Dental Claims Specialist
Dental Claims Specialist
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Job Description
You are as unique as your background experience and point of view. Here youll be encouraged empowered and challenged to be your best self. Youll work with dynamic colleagues - experts in their fields - who are eager to share their knowledge with you. Your leaders will inspire and help you reach your potential and soar to new heights. Every day youll have new and exciting opportunities to make life brighter for our Clients - who are at the heart of everything we do. Discover how you can make a difference in the lives of individuals families and communities around the world.
Job Description:
As a Dental Specialist you will be responsible for carrying out the claims examination process of dental claims with higher complexity and providing the team with expert analysis of complicated or unusual claims. The Dental Specialist is responsible for ensuring the accurate and timely processing of complex claims and estimates for reimbursement to our members. This includes assessing dental x-rays and claims reviewing complex claims for completeness and producing internal and external correspondence. There are clearly defined expectations with regards to service standards productivity and quality targets and the maintenance of confidential information.
What will you do
Review complex claims and estimates for completeness and follow processes for incomplete information on claims
Assess and adjudicate complex claims and estimates
Assessing includes studying dental information and plan provisions researching documenting results and communicating verbally and or in writing with the client (member/sponsor) to obtain additional details in order to make an informed decision
Meet production and quality standards set for individuals teams and department (timeliness quality and service)
Handle external and internal inquiries via written correspondence e-mails and telephone as required
Participate in departmental projects as required
Work in conjunction with the Dental Consultant on contentious cases and with other departments/offices within the company in order to meet customer expectations
What do you need to succeed
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
Whats in it for you
Were proud to be recognized as a company with a 2024 Most Trusted Executive team by Great Place to Work Canada
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 well 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.
The Base Pay range is for the primary location for which the job is posted. It may vary depending on the work location of the successful candidate or other addition to Base Pay eligible Sun Life employees participate in various incentive plans payment under which is discretionary and subject to individual and company performance. Certain sales focused roles have sales incentive plans based on individual or group sales results.
Diversity and inclusion have always been at the core of our values at Sun Life. A diverse workforce with wide perspectives and creative ideas benefits our Clients the communities where we operate and all of us as colleagues. We welcome applications from qualified individuals from all backgrounds.
Persons with disabilities who need accommodation in the application process or those needing job postings in an alternative format may e-mail a request to .
We are proud to be a hybrid organization that offers our employees the choice and flexibility to work from both the office and virtually based on the needs of the business our Clients and you! Several work options are available and can be discussed throughout the selection process depending on the role requirements and individual needs.
We thank all applicants for showing an interest in this position. Only those selected for an interview will be contacted.
Salary Range:
54000/54 000 - 91000/91 000Job Category:
Claims - Health & DentalPosting End Date:
26/09/2025Required Experience:
Unclear Seniority
Employment Type
Full-Time
