Help protect integrity, strengthen compliance, and improve how we serve our members.
At Liberty Dental Plan, our Internal Audit team plays a critical role in ensuring accuracy, compliance, and operational excellence across our organization. We are looking for a detail‑driven, analytical Sr. Internal Auditor who brings strong claims or audit experience and a collaborative mindset to help support regulatory readiness, claims accuracy, and continuous improvement across the enterprise.
If you enjoy digging into data, identifying trends, and working cross‑functionally to drive quality and accountability, this role offers meaningful impact in a mission‑driven organization.
What You’ll Do
As a Sr. Internal Auditor, you will support day‑to‑day audit activities across claims, utilization management, and system configuration while playing an important role in regulatory compliance and quality improvement initiatives.
Key Responsibilities
- Audit and analyze claims data to ensure processing accuracy and service‑level standards are met at individual, group, and enterprise levels.
- Review claims processing, specialty referrals, prior authorizations, benefit plans, group setup, and system configuration to confirm alignment with contracts and policies.
- Validate benefit schedules, frequency limits, and provider compensation schedules to ensure accurate system configuration and payments.
- Create and maintain claims and UM client file packets used for external audits and internal reviews.
- Support CMS ODAG and CMS Part C audits, including file preparation, tracking, and data validation activities.
- Analyze audit results, identify trends, and document findings to support training, calibration, and continuous improvement efforts.
- Collaborate with Claims, UM, Compliance, IT, and other departments to follow up on audit findings and ensure timely corrections.
- Support and test automation tools and internal bots to help meet regulatory and client requirements.
- Assist with departmental reporting, training activities, and the development or refinement of audit policies and procedures.
- Maintain professionalism and confidentiality when handling sensitive audit information.
- Perform additional duties as assigned.
What Makes This Role a Senior Opportunity
- Participation in CMS ODAG and Part C audits
- Primary contributor to UM and Claims file packet creation
- Involvement in quality improvement initiatives and system enhancement discussions with leadership and IT
- Opportunity to influence audit practices and support multiple departments through shared audit resources.
What You Bring
Experience & Education
- Preferred Bachelor’s degree or equivalent combination of education and relevant experience
- Minimum 2 years of experience in claims processing, claims auditing, or claims data analysis (Dental PPO or DHMO environment strongly preferred)
- 1+ year of internal audit experience, preferably within a dental or healthcare setting
Skills & Knowledge
- Strong understanding of dental claims processing and audit methodologies
- Proficiency in Microsoft Word and Excel
- Strong analytical, reporting, and trend‑analysis skills
- Excellent attention to detail and comfort working with complex data
- Ability to work independently while managing multiple priorities
- Strong written and verbal communication skills
- Discretion and professionalism when handling confidential information
- Collaborative mindset with the ability to promote teamwork across departments
Why Liberty Dental Plan
At Liberty, we are committed to improving lives by expanding access to quality dental care. Our culture emphasizes collaboration, integrity, and accountability—and our People Philosophy centers on empowering employees to thrive while making a meaningful difference for the members and communities we serve.
This role offers the opportunity to:
- Work remotely in a supportive, mission‑driven environment
- Partner closely with Compliance, Claims, UM, and IT teams
- Contribute to regulatory readiness and operational excellence
- Grow your audit expertise within a reputable dental benefits organization
