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Internal Auditor

Role overview

Qualifications

  • Minimum 2 years of experience in claims processing
  • At least 1 year of auditing experience required
  • Bachelor’s degree in a related field or equivalent experience
  • Experience in a Dental PPO or DHMO environment strongly preferred

Responsibilities

  • Conduct high-volume audits (approx. 1,250/month) to ensure claims accuracy, compliance, and adherence to contractual requirements
  • Analyze claims data, identify trends, and generate actionable insights to improve operational performance
  • Review and validate group setups, including benefit schedules, frequencies, and plan configurations
  • Document audit findings and partner with internal teams to implement timely and effective corrections

Key facts

Other skills

  • Analytical Skills
  • Microsoft Excel
  • Microsoft Word
  • Problem Solving
  • Detail Oriented
  • Organizational Skills
  • Non-Verbal Communication
  • Time Management

About the company

LIBERTY Dental Plan logo

LIBERTY Dental Plan

Health Insurance (Payers)

Liberty Dental Plan is a managed dental care benefits administrator specializing in government-sponsored programs, provides carve-outs to health plans, and arranges for the delivery of cost-effective, quality dental care services using one of the largest and most credentialed dental networks. Our goal is to improve the quality of our partners' dental programs and improve the overall health of their members.

Company details

IndustryHealth Insurance (Payers)
Company size1001 - 5000

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Job description

Make an Impact at LIBERTY

At Liberty Dental Plan, we are committed to enhancing the oral health of the communities we serve through operational excellence, integrity, and innovation. As an Internal Auditor, you play a critical role in ensuring accuracy, compliance, and continuous improvement across our claims and provider systems—directly supporting our mission to deliver high-quality, accessible care.

This role is ideal for a detail-oriented, analytical professional who thrives in a fast-paced environment and enjoys uncovering insights that drive smarter decisions and stronger outcomes.


What You’ll Do

As an Internal Auditor, you will evaluate the accuracy and integrity of claims processing, group setup, and provider compensation structures across individual, group, and enterprise levels.

Core Responsibilities

  • Conduct high-volume audits (approx. 1,250/month) to ensure claims accuracy, compliance, and adherence to contractual requirements
  • Analyze claims data, identify trends, and generate actionable insights to improve operational performance
  • Review and validate group setups, including benefit schedules, frequencies, and plan configurations
  • Audit provider fee schedules and compensation structures to ensure alignment with contractual agreements
  • Document audit findings and partner with internal teams to implement timely and effective corrections
  • Monitor service levels and compliance reporting for performance guarantee groups
  • Support ongoing process improvement initiatives and recommend enhancements
  • Collaborate cross-functionally with Operations, Compliance, and IT to strengthen systems and workflows
  • Maintain confidentiality and integrity of audit data at all times

How You’ll Lead (SMILE Leadership Behaviors)

  • Serve with Integrity: Ensure compliance and accuracy in every audit
  • Make Data-Driven Decisions: Translate audit findings into meaningful insights
  • Innovate & Improve: Identify opportunities to optimize processes and systems
  • Lead Through Collaboration: Partner across teams to resolve issues and elevate performance
  • Engage & Empower: Share knowledge and contribute to training and development efforts

What You’ll Bring

Experience

  • Minimum 2 years of experience in:
    • Claims processing
    • Claims auditing
    • Data analysis and review
  • At least 1 year of auditing experience required
  • Experience in a Dental PPO or DHMO environment strongly preferred

Education

  • Bachelor’s degree in a related field
    OR equivalent combination of education and relevant experience

Key Skills & Capabilities

  • Strong knowledge of claims processing and audit methodologies
  • Advanced analytical and problem-solving skills
  • Proficiency in Microsoft Excel and Word
  • Ability to interpret complex data and identify trends
  • High attention to detail with strong organizational skills
  • Effective written and verbal communication
  • Ability to manage workload independently and meet deadlines
  • Sound judgment and discretion when handling sensitive information

What Sets You Apart

  • Passion for continuous improvement and operational excellence
  • Ability to connect data insights to real business impact
  • Comfortable working in a high-volume, metrics-driven environment
  • Collaborative mindset with a proactive approach to problem-solving

Why LIBERTY?

At Liberty Dental Plan, we live our PEOPLE philosophy by investing in our team members’ growth, well-being, and success. You’ll be part of a collaborative culture where your expertise is valued and your contributions directly impact the health of the communities we serve.


Additional Details

  • Performs other duties as assigned
  • May participate in policy development and system enhancement initiatives
  • Works within established protocols to maintain a productive, compliant work environment

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MR

Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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