[Hiring] Claims Referral Specialist I @Liberty Dental Plan Careers

Role Description

Liberty Dental Plan is seeking a detail-oriented Claims Referral Specialist I to support the daily processing of dental claims, pre-authorizations, and specialty referrals. In this role, you will be responsible for reviewing and processing claims and referral requests in accordance with plan benefits, service level agreements (SLAs), and regulatory requirements.

Working closely with internal teams, providers, and other stakeholders, you will play an important role in ensuring accurate claim adjudication, timely referral processing, and exceptional service to our members and provider partners.

Pay Range: $20-$22 per hour

Position Type: Hourly, Non-Exempt

What You'll Do

• Process dental claims, pre-authorizations, and referral requests within established turnaround times and quality standards.
• Review claims and referrals for benefit eligibility and coverage determination.
• Accurately enter and maintain data within claims processing systems.
• Interpret plan benefits, policies, and procedures to ensure proper claim adjudication.
• Maintain current knowledge of company guidelines, service level agreements, and regulatory requirements.
• Research and resolve claim discrepancies, incomplete documentation, and processing issues.
• Communicate professionally with providers, members, and internal departments regarding claim or referral status, requirements, and resolutions.
• Meet or exceed established production and quality goals.
• Promote teamwork and collaborate effectively with colleagues across departments.
• Support process improvements and operational efficiency initiatives.
• Maintain confidentiality and compliance with company policies and industry regulations.
• Perform other duties as assigned.

Qualifications

• High school diploma or GED.
• Minimum of one (1) year of dental claims processing experience.
• Working knowledge of Microsoft Office, including Excel, Outlook, and Word.
• Strong organizational skills and attention to detail.
• Excellent communication and customer service skills.
• Ability to work independently and meet performance objectives.
• Ability to manage multiple priorities while maintaining accuracy and productivity.
• Minimum typing speed of 40 words per minute.
• 10-key proficiency by touch.
• Ability to understand and follow written and verbal instructions.

Preferred Qualifications

• Registered Dental Assistant (RDA) certification.
• Front office or back office dental office experience.
• Experience processing dental referrals, pre-authorizations, or treatment estimates.
• Familiarity with dental terminology, CDT coding, and benefit plans.
• Experience working in a managed care or dental insurance environment.

What Will Help You Succeed

• Takes pride in producing accurate and timely work.
• Enjoys problem-solving and researching claim-related issues.
• Maintains strong attention to detail while working in a fast-paced environment.
• Adapts quickly to changing priorities and business needs.
• Works collaboratively and contributes positively to team goals.
• Demonstrates accountability, professionalism, and reliability.

Work Environment

This position is generally performed in a remote environment. The role is primarily sedentary and involves extended periods of sitting, typing, and close-range visual work.

Compensation

In the spirit of pay transparency, the base salary range for this position is $20-$22 per hour, not including fringe benefits or potential bonuses. At Liberty, your final compensation will be determined by factors such as geographic location, skills, education, and experience. We are committed to pay equity and also consider internal equity when making compensation decisions.

Please note that the range listed represents the full salary range for this role. Typically, offers are not made at the top of the range to allow for future salary growth.

What Liberty Offers

• Competitive pay structure and savings options.
• 401(k) retirement plan with employer match and Roth options.
• Affordable medical insurance.
• Employer-paid dental coverage for eligible employees and dependents.
• Vision insurance.
• Company-paid life and AD&D insurance.
• Flexible Spending Accounts (FSA).
• Voluntary accident, critical illness, and hospital indemnity coverage.
• Long-term disability coverage.
• Employee wellness programs and resources.
• Employee Assistance Program (EAP).
• Generous vacation and sick leave programs.
• Paid company holidays.
• Tuition reimbursement opportunities.
• Remote or hybrid work options for eligible positions.

Location

Our employees are distributed across multiple office locations within the United States. Employees must be authorized to work in the United States and are not permitted to work outside of the country.