Dental Claims Consultant
2 days ago
Job Description: Hybrid Role The claims consultant will support the day to day accurate and timely handling of claims.
This includes managing escalated client issues, subrogation and claims involving legal case management, ombudsmen claims and client impact situations. Assisting and monitoring questions from analysts/seniors
to promote accurate and timely adjudication of claims and directing further investigations where necessary. Serve as the Claims Representative and key participant for install meetings, client requested tours and demonstrations, training roll outs and change initiatives.
Also defined are competency levels for Teamwork, Customer Service, Giving and Receiving Feedback and Problem-solving and Decision-making.
What will you do: Understand systems, processes and other GB departments (Client Services, Group IT, etc.);
Process and resolve escalated claims issues with Plan Sponsors, Plan Members, Business Development (Account Executives, Service Representatives), GBCCC and Member Impact Team(MIT). Understand systems, processes and other GB departments (Client Services, Group IT, etc.);
Field and manage questions from the analysts/seniors
Attend pre-install meetings and provide input from a claims adjudication perspective
Investigate and resolve Ombudsman’s cases, includes contacts with ombudsman’s office and client (both verbal and written communication required);
Successfully support claims team through change initiatives
Lead and manage on-going training roll-outs
Participate in client tours and claims demonstrations
Serve as claims representative for Best Practice
Run focus reports and contribute to management of results to ensure service standards are met
Participate in departmental or GB projects as required
Maintain confidentiality and clean desk policy at all times;
Understand and adhere to Sun Life Financial Code of Business Conduct;
Participate in the establishment of individual performance plans;
Attend training as required;
Contribute to the overall success of ACT; keep Customer satisfaction (our direct influence on the Customer Loyalty Index and Member Loyalty Index) in mind and remain conscious of our departmental commitments;
Support on-going changes within the department and across business units.
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
As this position is posted in several locations, we specify that bilingualism (French, English, both oral and written) is required for Quebec only to answer calls from English and French-speaking clients across Canada or worldwide
Decision-making: Know how to navigate within and outside the department to resolve issues, conduct further investigation, identify inconsistencies in adjudication practices and identify training needs.
Ensure that reference material inconsistencies are escalated to the appropriate area so that all documents are properly aligned.
Organizational Impact and Challenges: Know what Health and Dental Claims service standards are; ensure that claims/issues are managed or routed to the correct person/department to meet claim standards and satisfy clients need.
Notes/Unique Requirements: Overtime may be required as dictated by business need
This role requires a set production and quality target range to be met daily
Good knowledge of the special policies.
What’s in it for you? We’re proud to be recognized as a company with a 2023 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, 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.
When a new position becomes available which matches your background and experience, the base pay range will be disclosed and correspond to the opportunity Sun Life will consider you for.
In 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
thebrightside@sunlife.com
.
At Sun Life we strive to create a flexible work environment where our employees are empowered to do their best work. Several flexible 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.
Job Category: Claims - Health & Dental Posting End Date: 05/01/2025
-
Dental Claims Consultant
2 days ago
North York (York Mills / Silver Hills), Canada Sun Life Financial Full timeYou are as unique as your background, experience and point of view. Here, you’ll be encouraged, empowered and challenged to be your best self. You'll 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, you'll...
-
Dental Claims Specialist
2 days ago
North York (York Mills / Silver Hills), Canada Sun Life Financial Full timeYou are as unique as your background, experience and point of view. Here, you’ll be encouraged, empowered and challenged to be your best self. You'll 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, you'll...
-
Dental Claims Specialist
2 days ago
North York (York Mills / Silver Hills), Canada Sun Life Financial Full timeYou are as unique as your background, experience and point of view. Here, you’ll be encouraged, empowered and challenged to be your best self. You'll 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, you'll...
-
Jr. Claims Adjudicator
5 months ago
North York, Canada People Corporation Full timeWe are seeking a Jr. Claims Adjudicator to join our BPA team in North York. The Junior Claims Adjudicator provides timely and accurate adjudication and reimbursement of benefit claims submitted by members covered under the L.I.U.N.A. Local 183 Member’s Benefit Trust Fund. He or she provides courteous and professional customer service while maintaining...
-
Dental Receptionist
5 months ago
North York, Canada Platinum Dental Care Full time**Experience**: Minimum 4 years of experience in a dental setting, experience with Tracker and RecallMax software preferred **Responsibilities**: - Coordinate treatment plans for patients, including scheduling appointments, explaining procedures, and obtaining necessary authorizations. - Serve as a liaison between patients and dental providers, ensuring...
-
Dental Treatment Coordinator
2 months ago
North York, Canada Platinum Dental Care Full timeWe are seeking an experienced Dental Treatment Coordinator to join our team. **Experience**: Minimum 5 years of experience in a dental setting, experience with Tracker and RecallMax software preferred **Responsibilities**: - Coordinate treatment plans for patients, including scheduling appointments, explaining procedures, and obtaining necessary...
-
Dental Receptionist/assistant
3 months ago
North York, Canada JANE STREET DENTAL Full timeLooking for a part time receptionist / dental assistant for Saturdays '''Duties:''' - Greet and welcome patients as they arrive at the dental office - Answer phone calls and schedule appointments for patients - Verify insurance coverage and collect necessary patient information - Provide excellent customer service - Experience with entering procedures,...
-
Dental Receptionist
6 months ago
York, Canada Weston Dental Office Full time'''Duties''' - Greet and welcome patients as they arrive at the dental office - Answer phone calls and schedule appointments for patients - Verify insurance coverage and collect necessary patient information - Maintain electronic medical records using dental software such as Tracker - Assist with billing and processing insurance claims - Provide excellent...
-
Dental Receptionist/ Front Desk
2 months ago
North York, Canada Chroma Dental Full time**Job description** **Dental Receptionist / Front Desk** **New graduates are welcome!** Please attach your resume. We look forward to speaking with you. **Responsibilities and duties**: Provide excellent customer service as the first point of contact to patients Recording all patient information, such as medical history, insurance breakdowns Performing...
-
Dental Receptionist
1 month ago
North York, Canada North York Dental Clinic Full time**Job Summary** **Responsibilities** - Greet patients warmly as they arrive at the dental office and assist them with check-in procedures. - Schedule and confirm appointments using Dentrix or similar dental software. - Manage patient records, ensuring all information is accurate and up-to-date. - Answer phone calls promptly, addressing inquiries and...
-
Dental Receptionist
3 months ago
North York, Canada WALK IN DENTAL CLINIC Full time**Job description** Looking for an enthusiastic and goal-oriented Individual to join our growing and busy dental clinic. Must have flexible availability including Saturdays and Sundays. Previous experience is an asset. Qualifications include: Excellent English speaking and writing skills Previous experience working as a Dental Receptionist Highly...
-
Dental Receptionist/customer Service
6 months ago
North York, Canada NYSD DENTAL OFFICE Full timeEstablished dental office in GTA looking for an outgoing, organized, and computer savvy Dental Receptionist.The successful applicant will also have strong communication and interpersonal skills. Dental Assisting experience would be an asset. **Responsibilities**: - Greet and welcome patients as they arrive at the dental office - Answer phone calls and...
-
Dental Receptionist
5 months ago
York, Canada Corktown Dental Centre Full timeOur modern and fast-paced office is seeking a part-time Dental Receptionist to join our team, with the possibility to become full-time as the office is rapidly growing. We are looking for a reliable, detail-oriented, and friendly person that focuses on patient care and has a strong work ethic with excellent customer service and communication skills. You...
-
Dental Receptionist
1 week ago
North York, Canada Smiles at North York Dental Full timeDuties include assisting dentists during procedures, sterilizing instruments, taking radiographs, ensuring organized treatment rooms, patient outreach, booking appointments, greeting patients, and other front-desk duties. **Job Overview** **Responsibilities** - Greet patients warmly and manage the check-in and check-out process efficiently. - Schedule and...
-
Junior Claims Adjudicator
5 months ago
North York, Canada People Corporation Full timeWe are seeking a Junior Claims Adjudicator to join our BPA team in North York. **The Junior Claims Adjudicator provides timely and accurate adjudication and reimbursement of benefit claims submitted by members covered under our clients’ Benefit Trust Fund. He or she provides courteous and professional customer service while maintaining departmental...
-
Claims Processor
3 weeks ago
North York, Canada Sterling Auto Body Inc. Full timeSterling Auto Body Inc. is looking for a **Claims Processor** to join our team. In this role, you will manage insurance claims, coordinate with insurance companies, and ensure timely and accurate claim processing for our customers. You will provide support throughout the process, from initial submission to claim resolution, ensuring a seamless experience for...
-
General Manager
3 months ago
North York, Canada Anytime Dental Full timeDue to Anytime Dental Group’s unique philosophy, we have seen the most success in bringing leaders in at the ground level and rolling up their sleeves to learn how we operate prior to them taking on leadership positions. Specifically, while paid at a manager level, you would start as a Concierge at one of our clinics for 1-2 months, then move into the...
-
Claims Coordinator
6 months ago
North York, Canada TMC Full timeAre you a skilled professional with exceptional organizational and communication abilities? Our clinic is seeking a dedicated Claims Coordinator to join our team. If you are detail-oriented, have a strong understanding of medical and insurance processes, and excel in delivering top-notch customer service, we want to hear from you! **Responsibilities will...
-
Claims Manager
2 months ago
North York, Canada Navacord Full time**COMPANY PERKS** - A very specialized team with a market-leading value proposition - A truly collaborative environment - Great learning and growth opportunities - Hybrid remote and flexible schedule - A competitive compensation package (Base Salary, Performance Bonus + commission on New Business) - Full Benefits Package - Profit Sharing Plan - Professional...
-
Dental Receptionist/treatment Coordinator
6 months ago
North York, Canada Galloro Dental Group (Don Mills & Summerhill) Full timeWe are seeking a receptionist/treatment coordinator who is versatile and ready to join our exceptional team. The selected individual will need to work between both our locations (Summerhill and Don Mills). We desire someone enthusiastic about dentistry with outstanding administrative skills. We are looking for someone who is passionate about dentistry and...