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

Role Description

At Liberty Dental Plan, we are seeking an experienced and detail-oriented Claims Referral Specialist II to join our team and support the accurate and timely processing of dental claims, pre-authorizations, and referrals. This role is ideal for individuals who thrive in a fast-paced environment, enjoy problem-solving, and are passionate about delivering quality results while maintaining high productivity and accuracy standards.

The Claims Referral Specialist II is responsible for processing dental claims and/or pre-authorizations and referrals within established plan timelines. This position requires advanced knowledge of claims processing, strong analytical skills, and the ability to manage a broad scope of work while meeting production and quality expectations.

As a Level II specialist, you will be expected to:

• Process dental claims, pre-authorizations, and referrals accurately and within established service level agreements.
• Review and determine member benefits in accordance with plan guidelines and policies.
• Process claims involving Coordination of Benefits (COB) and Orthodontics as applicable.
• Maintain a high level of productivity while meeting quality and accuracy standards.
• Perform high-volume data entry with exceptional attention to detail.
• Stay current on state regulations, plan requirements, and service level standards.
• Support a collaborative and positive team environment.
• Follow established company policies, procedures, and safety protocols.
• Assist with departmental projects and perform additional duties as assigned.

Qualifications

• High school diploma or GED.
• Minimum of one to three years of dental claims processing or related experience.
• Working knowledge of Microsoft Office, including Excel, Outlook, and Word.
• Ability to work independently and consistently meet performance expectations.
• Typing speed of at least 40 words per minute.
• Strong 10-key data entry skills.
• Excellent communication, customer service, and organizational skills.
• Strong attention to detail and ability to manage multiple priorities.

Requirements

• Registered Dental Assistant (RDA) certification (preferred).
• Front office and/or back office experience in a dental practice (preferred).

Benefits

• Competitive pay structure and savings options to help you reach your financial goals.
• Excellent 401(k) retirement benefits, including employer match, Roth IRA options, and immediate vesting during the Safe Harbor period.
• Affordable medical insurance, with low-cost premiums for employee-only coverage.
• 100% employer-paid dental coverage for employees and eligible dependents.
• Vision insurance with low-cost premiums for employee-only coverage and dependents.
• Company-paid basic life and AD&D insurance, equal to one times your base salary.
• Flexible Spending Accounts for healthcare and dependent care expenses.
• Voluntary benefit programs, including accident, critical illness, and hospital indemnity insurance.
• Long-term disability coverage.
• Expansive wellness programs, including company-wide wellness challenges and gym discounts.
• Employee Assistance Program (EAP) to support mental health and well-being.
• Generous vacation and sick leave policies, with the ability to roll over unused time.
• 10 paid company holidays.
• Tuition reimbursement for eligible educational expenses.
• Remote or hybrid work options available for various positions.