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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.

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.

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.

Skills

Dental claims processing
Coordination of Benefits (COB)
Orthodontic claims processing
Microsoft Office (Excel, Outlook, Word)
Data entry
Analytical skills
Problem-solving skills
Communication skills
Customer service skills

Location

Eastern Time Zone - Uniondale, NY
Remote - East Coast

Work Type

Full Time
Remote

Experience Level

Minimum one (1) year of dental claims processing experience

Education Level

High School Diploma or GED

Salary/Compensations

$20.00 - $25.00 an hour

Benefits

Competitive pay structure and savings options
Excellent 401(k) retirement benefits, including employer match, Roth IRA options, immediate vesting during the Safe Harbor period, and access to professional financial advice
Affordable medical insurance, with low-cost premiums for employee-only coverage and Liberty subsidizing the cost for eligible dependents
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

About the Company

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.
At Liberty Dental Plan, you'll be part of a mission-driven organization dedicated to delivering exceptional service to members, providers, and communities.
We value collaboration, accountability, continuous improvement, and professional growth.
Your expertise will directly contribute to ensuring members receive timely and accurate claims processing and support.

Equal Opportunity

Liberty Dental Plan is an Equal Opportunity Employer.
We celebrate diversity and are committed to creating an inclusive environment for all employees.
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.
Liberty Dental Plan is an Equal Opportunity Employer / VETS / Disabled.