Claims Referral Specialist II

LIBERTY DENTAL PLAN CORPORATION•Uniondale, NY

2d•$20 - $25•Remote

About The Position

At Liberty Dental Plan, we are committed to improving the oral health of the communities we serve through quality care, exceptional service, and operational excellence. We are seeking a detail-oriented and experienced Claims Referral Specialist II to join our Claims team and play a vital role in ensuring accurate and timely claims processing for our members and providers. About the Role As a Claims Referral Specialist II, you will be responsible for processing dental claims, pre-authorizations, and referrals within established service level agreements and regulatory guidelines. This role is ideal for someone who thrives in a fast-paced, production-driven environment, enjoys analytical work, and takes pride in maintaining high levels of accuracy and quality. The successful candidate will bring strong dental claims knowledge, experience with Coordination of Benefits (COB) and Orthodontic claims processing, and the ability to collaborate effectively across departments while working independently in a remote setting. A Valid New York Adjuster License is required for this role and is considered a critical qualification for success in this position.

Requirements

High School Diploma or GED.
Minimum one (1) year of dental claims processing experience.
Valid New York Adjuster License.
Must reside in an East Coast state.
Experience processing claims, including Coordination of Benefits (COB) and Orthodontic claims.
Strong analytical and problem-solving skills.
Ability to meet production and quality goals in a high-volume environment.
Proficiency with Microsoft Office, including Excel, Outlook, and Word.
Typing speed of at least 40 words per minute.
10-key by touch proficiency.
Strong communication and customer service skills.
Ability to work independently while contributing to a collaborative team environment.

Nice To Haves

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

Responsibilities

Process dental claims, pre-authorizations, referrals, and benefit determinations accurately and efficiently.
Review and adjudicate claims in accordance with plan guidelines, state regulations, and service level agreements.
Process claims involving Coordination of Benefits (COB) and Orthodontic services.
Perform high-volume data entry while maintaining established quality and productivity standards.
Maintain current knowledge of claims processing requirements, regulatory updates, and departmental procedures.
Collaborate with internal teams to resolve claim-related issues and support operational goals.
Promote a positive, team-oriented work environment.
Maintain confidentiality and professionalism in all interactions.
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, BurnAlong memberships, 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.