Remote Dental Claims Processing Jobs in Riverside, CA

Do you thrive at the intersection of claims expertise, system configuration, and crossfunctional collaboration? Are you energized by solving complex Utilization Management (UM) and claims scenarios while ensuring systems work exactly as designed? LIBERTY Dental Plan is seeking a System Configuration Analyst to help ensure our claims and UM systems are accurate, efficient, and aligned with benefit design and regulatory expectations.

In this highly collaborative role, you’ll partner with Claims, UM, Account Management, Quality Management, Compliance, and IT teams to configure, test, and maintain system logic that directly supports highquality service delivery and sound operational outcomes.

You’ll support the endtoend effectiveness of claims and UM system configuration through testing, analysis, and coordination:

• Coordinate, track, and complete claims and UMrelated projects
• Analyze and process complex claim and UM scenarios
• Assist with benefit implementation and claims/UM system configuration
• Coordinate with crossfunctional teams to implement and maintain member notifications related to claim and UM decisions and outcomes
• Support research projects and new business implementations as needed
• Partner with management to create, update, and maintain departmental policies and procedures
• Audit and test existing system code rules and provide recommendations for improvement
• Audit and test new and existing benefit setups related to claims and UM adjudication
• Support Crystal Report implementation related to claims and UM activities
• Perform other duties as assigned

• High School Diploma or GED
• Minimum of 2 years of experience in PPO and HMO claims processing, billing, and/or auditing
• Looking for someone with HSP systems knowledge, dental procedure knowledge, HSP denial explanations, Service restrictions, Basic data analytics experience
• Proficiency with Microsoft Office tools, including Word, Excel, and Access
• Strong written and verbal communication and presentation skills
• Advanced analytical skills, including datamining, reporting, and analysis
• Ability to reason logically, make sound decisions, and communicate effectively under varied circumstances
• Ability to multitask and work efficiently with interruptions or competing priorities

• Bachelor’s degree
• Prior auditing experience

You are someone who:

• Enjoys detailed, systemsfocused work and process testing
• Is comfortable navigating complex benefit and adjudication logic
• Collaborates effectively across departments with differing priorities
• Maintains composure and accuracy in fastpaced or highstress situations
• Takes pride in producing reliable, welldocumented results

• Primarily remote, officebased work
• Role involves extensive computer use, data review, and system testing
• Requires sustained attention to detail and coordination across multiple teams

If you’re motivated by precision, collaboration, and improving how claims and UM systems serve members and providers, we encourage you to apply and bring your expertise to LIBERTY Dental Plan.

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.

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.

• 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.

In the spirit of pay transparency, the base salary range for this position is $65,000 - $75,000 a year, 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.

Liberty Dental Plan is an Equal Opportunity Employer / VETS / Disabled.

No relocation assistance or sponsorship available at this time.