Claims Referral Specialist III
About The Position
Join Liberty Dental Plan and Make an Impact At Liberty Dental Plan, we are committed to improving oral health and delivering exceptional service to the members, providers, and communities we serve. We are seeking a highly experienced and detail-oriented Claims Referral Specialist III to join our team and play a critical role in ensuring the accurate and timely processing of dental claims, pre-authorizations, and referrals. This position is ideal for professionals who have advanced claims processing expertise, thrive in a fast-paced environment, and are passionate about delivering accuracy, quality, and outstanding service. About the Role The Claims Referral Specialist III is responsible for processing dental claims and/or pre-authorizations and referrals within established plan timelines while consistently meeting production and quality standards. As the most advanced level within the Claims Referral Specialist career path, this role requires the ability to process complex claims, referrals, and pre-authorizations across all lines of business, including specialized or high-priority client accounts. The ideal candidate is a self-starter with strong analytical skills, exceptional attention to detail, and a commitment to operational excellence.
Requirements
- High school diploma or GED.
- Minimum of one year of dental claims processing 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 benefits in accordance with plan guidelines, policies, and regulatory requirements.
- Process claims involving Coordination of Benefits (COB), Orthodontics, and other complex claim types.
- Handle specialized client claims, referrals, and pre-authorizations requiring advanced knowledge and expertise.
- Perform high-volume data entry while maintaining accuracy and quality standards.
- Maintain current knowledge of service level agreements, state regulations, and departmental procedures.
- Meet or exceed productivity, quality, and turnaround time goals.
- Support a collaborative team environment and contribute to departmental success.
- Follow established policies, procedures, and safety protocols.
- Perform additional duties and special projects 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.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
