Hybrid Dental Claims Specialist

Posted last month

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About the role

  • Carrying out the claims examination process of dental claims with higher complexity and providing expert analysis of complicated or unusual claims
  • Ensure accurate and timely processing of complex claims and estimates for reimbursement to members
  • Assess dental x-rays and claims, review complex claims for completeness and follow processes for incomplete information on claims
  • Assess and adjudicate complex claims and estimates, including studying dental information and plan provisions, researching, documenting results
  • Communicate verbally and/or in writing with the client (member/sponsor) to obtain additional details to make informed decisions
  • Produce internal and external correspondence and handle external and internal inquiries via written correspondence, e-mails and telephone
  • Meet production and quality standards set for individuals, teams and department (timeliness, quality and service)
  • Participate in departmental projects as required and work with Dental Consultant on contentious cases
  • Collaborate with other departments/offices within the company to meet customer expectations

Requirements

  • Diploma in Dental Hygiene (CEGEP/College or University)
  • Experience working in a dental clinic
  • Strong knowledge of Group Insurance - Dental claims
  • Customer service oriented
  • Excellent communication skills both verbal and written
  • Excellent problem solving skills
  • Self motivated
  • Team oriented
  • Ability to work in a changing environment
  • Strong decision making skills
  • Open to receiving and giving feedback

Benefits

  • Access to short-term assignments or ‘Gigs’ across the organization, to help you develop new skills and connections.
  • A collaborative and interactive team environment.
  • Charitable giving through our You Give, We Give program lets you give back to your community – and in many cases, we’ll match your contributions.
  • Care Days available for self-care or care of others (i.e., family or others you may support) and Sick Days to support your well-being.
  • Eligible Sun Life employees participate in various incentive plans (payment discretionary and subject to individual and company performance).
  • Hybrid work options: choice and flexibility to work from both the office and virtually; several work options available.

Job title

Dental Claims Specialist

Job type

Experience level

Mid levelSenior

Salary

CA$54,000 - CA$91,000 per year

Degree requirement

Associate's Degree

Location requirements

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