Claims Referral Specialist II

At Liberty Dental Plan, we are committed to improving oral health and providing exceptional service to our members, providers, and partners. We are seeking a detail-oriented Claims Referral Specialist II to play a critical role in ensuring accurate and timely processing of dental claims, referrals, and pre-authorizations.

This position is ideal for someone who thrives in a fast-paced environment, enjoys working independently while supporting a collaborative team culture, and has a strong understanding of dental claims processing and benefit administration.

The Claims Referral Specialist II is responsible for the daily processing of dental claims, referrals, and/or pre-authorizations while maintaining high standards for accuracy, quality, and productivity. This role requires a strong understanding of benefit determination, claims adjudication processes, service level agreements, and regulatory requirements.

• Process dental claims, referrals, pre-authorizations, and related transactions within established timelines and service level agreements.
• Perform accurate data entry and documentation.
• Determine eligibility and benefits while processing claims, specialty referrals, and pre-authorizations.
• Maintain current knowledge of processing requirements, state regulations, and service level agreements.
• Support a collaborative team environment and contribute to operational success.
• Follow established protocols to maintain a safe and productive work environment.
• Perform additional duties and special projects as assigned.

In this role, you will have advanced processing capabilities and be able to:

• Process all claims for your assigned location, including coordination of benefits (COB) and orthodontic claims, or
• Process pre-authorizations and referrals across all lines of business for the location and process claims for at least one line of business.

• High school diploma or GED.
• Minimum of 1 year of dental claims processing experience.
• Proficiency with Microsoft Office, including Excel, Outlook, and Word.
• Ability to work independently and consistently meet performance objectives.
• Typing speed of at least 40 words per minute.
• Proficiency with 10-key by touch.
• Strong communication, customer service, and interpersonal skills.

• Registered Dental Assistant (RDA) credential.
• Front office and/or back office dental office experience.

Successful candidates will demonstrate:

• Strong attention to detail and accuracy.
• The ability to understand and follow written and verbal instructions.
• Reliability, punctuality, and regular attendance.
• A team-first mindset and commitment to quality service.
• The ability to manage workload efficiently while meeting production and quality expectations.

• Office-based work environment with standard office equipment.
• Sedentary position that requires extended periods of sitting, typing, and close-range computer work.

At Liberty Dental Plan, your work directly supports members' access to dental care. You'll join a mission-driven organization that values collaboration, accuracy, continuous learning, and exceptional service. If you're looking for an opportunity to grow your expertise while making a meaningful impact, we'd love to hear from you.

If you have dental claims processing experience, strong attention to detail, and a passion for providing excellent service, apply today and become part of the Liberty Dental Plan team.

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.

Happy, healthy employees enhance our ability to assist our members and contribute more actively to their communities. That’s why Liberty offers competitive and attractive benefit packages for our employees. We strive to care for employees in ways that promote wellness and productivity.

• Competitive pay structure and savings options to help you reach your financial goals.

• Excellent 401(k) retirement benefits, including employer match, Roth IRA options, immediate vesting during the Safe Harbor period, and access to professional financial advice through Financial Engines.
• Affordable medical insurance, with low-cost premiums for employee-only coverage. Liberty subsidizes the cost for eligible dependents enrolled in the plan.
• 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, with options to purchase additional supplemental coverage.
• 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.

In the spirit of pay transparency, the base salary range for this position is $20.00 - $25.00 hourly, not including fringe benefits or potential bonuses. At Liberty, your final base salary will be determined by factors such as geographic location, skills, education, and experience. We are committed to pay equity and also consider the internal equity of our current team members when making final compensation decisions.

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

Liberty Dental Plan commits to maintaining a work environment that acknowledges all individuals within the workplace and will continue to engage in practices that are inclusive of all backgrounds, experiences, and perspectives. We strive to have every person within the organization have a sense of belonging while encouraging individuals to unleash their full potential. Liberty will leverage diverse perspectives in building high performance teams and organizational culture. 

Liberty Dental Plan will continue to strengthen and develop external partnerships by providing equitable health care access and improving population health in the communities we serve. 

We comply with all applicable laws and regulations on non-discrimination in employment, recruitment, promotions, and transfers, as well as work authorization and employment eligibility verification requirements.

Liberty Dental Plan is an Equal Opportunity Employer / VETS / Disabled.

No relocation assistance or sponsorship available at this time.