Sr. Internal Auditor

Job DetailsJob Location: Remote - Corp - Tustin, CA 92782Position Type: Full TimeJob Shift: DayJob Category: Insurance Claims
a {
text-decoration: none;
color: #464feb;
}
tr th, tr td {
border: 1px solid #e6e6e6;
}
tr th {
background-color: #f5f5f5;
}




a {
text-decoration: none;
color: #464feb;
}
tr th, tr td {
border: 1px solid #e6e6e6;
}
tr th {
background-color: #f5f5f5;
}



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

Location

Our employees are distributed in office locations in multiple markets across the United States. We are unable to hire or allow employees to work outside of the United States.

 

What Liberty Offers

Happy, healthy employees enhance our ability to assist our members and contribute more actively to their communities. That