Claims Referral Specialist II

Liberty Dental Plan Careers•Tustin, CA

22h•$20 - $25•Remote

About The Position

Join Liberty Dental Plan and Help Deliver Exceptional Service At Liberty Dental Plan, we are committed to improving oral health and providing outstanding service to our members and provider partners. 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. About the Role 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 all claims for your assigned location, including Coordination of Benefits (COB) and Orthodontics, or process pre-authorizations and referrals for all lines of business while demonstrating proficiency in claims processing.

Requirements

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.

Nice To Haves

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

Responsibilities

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.

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, 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.