Claims Referral Specialist II

Join a Team That Helps Deliver Access to Quality Dental Care

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.

About the Role

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.

What You'll Do

• 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.

What Makes a Claims Referral Specialist II?

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.

What You'll Bring

Required Qualifications

• 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.

Preferred Qualifications

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

Success in This Role

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.

Work Environment

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

Why Join Liberty Dental Plan?

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.

Apply Today

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.