Claims Referral Specialist II

Job DetailsJob Location: Remote - Corp - Tustin, CA 92782Join 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. What You'll Do 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. What You'll Bring Required Qualifications 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. Preferred Qualifications Registered Dental Assistant (RDA) certification. Front office and/or back office experience in a dental practice. Success in This Role Successful candidates will demonstrate: Advanced knowledge of dental claims and referral processing. Strong analytical and problem-solving abilities. A commitment to accuracy, quality, and customer service excellence. The ability to perform effectively in deadline-driven environments with productivity goals. Dependability, professionalism, and strong attendance. The ability to follow written and verbal instructions while working both independently and collaboratively. A positive, team-focused approach to achieving departmental goals. Work Environment This position is primarily performed in an office environment and involves extended periods of sitting, typing, and computer work. Employees should be comfortable working with standard office equipment and maintaining productivity throughout the workday. Why Join Liberty Dental Plan? At Liberty Dental Plan, every team member contributes to improving access to quality dental care for the communities we serve. We foster a collaborative, mission-driven culture where employees are empowered to make an impact through service, accountability, integrity, and teamwork. If you are an experienced dental claims professional looking to grow your career with an organization dedicated to service excellence, we encourage you to apply and become part of the Liberty Dental Plan team. Apply today and help us deliver the quality service our members and providers depend on every day. Location 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.   What Liberty Offers 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.   Our first-class benefits package supports employees and their dependents with: 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.   Compensation In the spirit of pay transparency, the base salary range for this position is $20.00 - $25.00 an hour, 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.   Sponsorship and Relocation Specifications Liberty Dental Plan is an Equal Opportunity Employer / VETS / Disabled. No relocation assistance or sponsorship available at this time.