Careers

Audit/Compliance Coordinator-Irvine, CA

04/25/2014

Summary

The Audit/Compliance Coordinator will be responsible for carrying out duties related to the ongoing administration of various Quality Management (QM)-related initiatives, programs, meetings and activities while coordinating various ongoing compliance activities as needed. 

Grievance Analyst - Irvine, CA

07/09/2014

Summary

The Grievance Analyst I will be responsible for intake of all member, provider and Health Plan Partner grievances and appeals.  In addition, the Grievance Analyst I will investigate and resolve certain member, provider and Health Plan Partner grievances and appeals.

Eligibility Specialist - Irvine, CA

07/09/2014

Summary

The Eligibility Specialist is responsible for updating the membership database, creating spreadsheets, and conducting data analysis. 

Data Entry Clerk - Las Vegas, NV & Tampa, FL

07/09/2014

Summary

Responsible for entering data from hard copy to KFI (key from image) and verifying provider or member information on EDI (Electronic Data Interchange) claim submissions.

 

Provider Relations Representative - Greater Chicago Area

07/09/2014

Summary

Individual will be responsible for developing strong provider network, recruiting and retaining network providers, training and educating providers to ensure compliance with LIBERTY’s policies and procedures. In need of a dedicated Network Manager with Medicaid experience and knowledge of programs in Illinois.

Internal Auditor - Irvine, CA

07/09/2014

Summary

This position is responsible for auditing of claims processing, specialty care referrals, group set up, performance guarantee groups, compliance reporting for specified groups, schedule of benefits and provider fee schedules at an individual, group as well as company-wide levels.  

Accounts Receivable Staff Accountant - Irvine, CA

07/09/2014

Summary

AR Staff Accountant will be responsible in monitoring cash receipt to ensure Liberty receive the payment accurately and timely.

Account Manager - Greater Chicago Area

07/09/2014

Summary

The Account Manager serves as the primary contact for clients and is focused on retention and client satisfaction. This person will be responsible for developing and maintaining long-term relationships with assigned clients and acting as a liaison between such clients and the operational components of the company.

Manager, Provider Relations - Greater Chicago Area

07/22/2014

LIBERTY Dental Plan has an immediate need for an experienced Manager to oversee our growing Professional Relations Department for our West Coast territories. This department manages the functions related to dental provider network development, contracts, education and servicing. Must be a self-starter, results driven, and interested in a fast paced environment. 

Director, Member Services - Las Vegas, NV

07/31/2014

Summary: 

The Director of Member Services will have overall strategic and operational responsibility for Member Services in Nevada and reports to the VP, Member Services.

This position gives direction and leadership toward the achievement of the organization’s philosophy, mission, strategy and its goals and objectives.  Responsible for managing daily activities of Member Services while ensuring the highest level of customer satisfaction, accuracy and compliance with all reporting benchmarks.  Also oversees long-term planning, technology strategies and continuous improvement of operational efficiencies.  Keeps current on State and Federal regulatory issues and industry activities and trends and is responsible for regulatory reporting.  Diligently works to foster a positive and cohesive work environment, while ensuring exemplary service is provided to all customers.

Claims Office Assistant - Las Vegas, NV

07/31/2014

Summary

Prepare all incoming mail and documentation for processing.

Claims/Referral Specialist - Irvine, CA (Union) & Las Vegas, NV

07/31/2014

Summary

Responsible for daily processing of dental claims and encounters within plan timelines; job function may differ depending on the specific area of assignment (e.g. claims, referrals, pre-estimates).

Account Manager, HealthCare Exchanges - Irvine, CA

07/31/2014

Summary

The Account Manager serves as the primary contact for clients.  The position will be responsible for proactively managing the acquisition and retention, delivery of services, and customer satisfaction for exchange business. This position coordinates and oversees all internal processes affecting Healthcare Exchange and Exchange partners.

SharePoint Business Analyst - Irvine, CA

07/31/2014

Summary

The purpose of a business analyst is to act as the interception point between the business and technical team. As such, you will be responsible for understanding business processes and translating these into a set of requirements as well as working with the development team on functional designs for the solution.

As a business analyst with a passion for technologies, you will be a key part of the LIBERTY team, working closely alongside our team and developers to enable us to deliver services, critical to the success of a growing organization.  You will need to understand the strengths and benefits of the Microsoft platform.

To be successful in the role, you'll need to understand how collaborative technologies can benefit business users, simplifying processes to achieve goals. You'll also be expected to be able educate business users.

Involved throughout the project lifecycle, a Business Analyst works with our team to understand as-is and to-be business process flows and requirements, as well as how information flows and changes through the business. The Business Analyst uses this information to assist in the design of the optimal IT solution and works closely with development and business users through implementation.

Jr. Financial Analyst - Irvine, CA

07/31/2014

Summary:  Jr. Financial Analyst with 2+ years related experience needed for fast growing dental insurance company. Position will be responsible to run financial data analysis reports to be presented to the management, assist in development of annual budget and monthly variance analysis, and other ad-hoc reporting. Strong Microsoft Access and Excel skills are a must.  Experience with insurance industry is a plus.

Senior Accountant - Irvine, CA

07/31/2014

Summary

The Accountant will be responsible for oversight and analysis of accounts receivable and accounts payable, enrollment reconciliation process, claim activity. Additional duties include coordinating month-end close process for multiple entities, reviewing financial statements for accuracy and completeness.

Applications Analyst - Irvine, CA

07/31/2014

Summary:  

This position will be responsible for the creation and\or maintenance of reports through Crystal, SQL Scripting, MS Reporting, and other various avenues. The IT Department supports all departments in meeting their reporting needs, and developing process improvements. Candidate should be detailed oriented, and able to work both as a team and on their own.

Credentialing Coordinator - Irvine, CA

07/31/2014

Summary

Responsible for the daily processing of credentialing and re-credentialing provider applications according to the National Committee for Quality Assurance (NCQA) guidelines using both internal and outsourced CVO systems and attaining credentialing documentation from provider offices.

EDI Specialist - Irvine, CA

07/31/2014

Summary

The EDI Specialist will be working with the IT Department in support of the various EDI submissions (Both incoming and outgoing). You will be supporting various departments in performing their EDI tasks, as well as implementation of new clients, and troubleshooting issues as they arise. LIBERTY Dental Plan is a fast growing dental insurance carrier looking to expand its EDI capabilities and meet our growing needs.

Member Services Representative - Las Vegas, NV & Tampa, FL

02/18/2014

Summary

Member Services Representatives (MSRs) are expected to provide excellent customer service to all incoming callers and will answer inquiries related to; dental benefits, eligibility, provider information, claims, grievance and appeals, fulfillment requests and other miscellaneous inquiries. MSRs must observe all local, state and federal guidelines and regulations.

Healthcare Underwriting Risk Analyst - Irvine, CA

02/18/2014

Summary: 

The Risk Analyst supports the establishment of market rates, reserve estimates, trend projections and other financial determinations for assigned markets and blocks of business.  The position requires independent analysis and the ability to think “outside the box” and continually consider new ideas and methodologies.  The position demands that the analyst relies on experience and judgment to plan and accomplish goals.

Regional Dental Director-Tampa, FL

03/14/2014

Summary

This position will be primarily responsible for representing LIBERTY Dental Plan to our health plan partner, and to be the “clinical presence” of LIBERTY in the Florida regional office, meeting with FL clients, responding to urgent requests for dental services, assisting the Internal Response Unit (IRU) with expedited case management issues as needed.  Routinely, the Dental Director will perform adjudication of dental claims and prospective requests for dental services (referrals and pre-authorizations) in Florida along with other Dental Consultants.  Additionally, this person will participate in other clinical review activities in Florida, such as participating in Florida Quality Management and Improvement activities such as clinical review of FL grievances, and meeting with FL clients for periodic joint operational meetings.  The position will be full or part time (two to four days per week at inception) depending on volume and demand.  The FL Dental Director also participates actively in Utilization Management and Review Programs.  LIBERTY Dental Plan administers commercial, Medicare Advantage and Medicaid programs in Florida.

The Dental Director will report to the National Dental Director and will collaborate with other corporate Dental Directors to assist in the development of clinical guidelines and Qualify Management Improvement processes to ensure process improvement and consistency in all clinical activities across the enterprise, yet specializing in any unique FL requirements. 

The FL Dental Director will be an active participant on the National Peer Review Committee in reviewing and analyzing Potential Quality Issues (PQIs), a member of Utilization Management Committee, Credentialing Committee and Quality Management & improvement Committee.

Director of Member Services-Las Vegas, NV

05/08/2014

Summary

The Director of Member Services will have overall strategic and operational responsibility for Member Services and reports to the VP, Member Services.

This position gives direction and leadership toward the achievement of the organization’s philosophy, mission, strategy and its goals and objectives.  Responsible for managing daily activities of Member Services and Fulfillment departments while ensuring the highest level of customer satisfaction, accuracy and compliance with all reporting benchmarks.  Also oversees long-term planning, technology strategies and continuous improvement of operational efficiencies.  Keeps current on State and Federal regulatory issues and industry activities and trends and is responsible for regulatory reporting.  Diligently works to foster a positive and cohesive work environment, while ensuring exemplary service is provided to all customers.

Professional Services Coordinator-Irvine, CA

06/02/2014

Summary

This position is responsible for processing of provider contracts, maintenance of provider database and providing support to the Supervisor of Administrative Services as well as Professional Relations management team.