Internal Auditor

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