Benefits Specialist

1 week ago

Etobicoke, Canada Prudent Benefits Administration Services Inc Full time

**Job Overview**
Prudent Benefits Administration Services Inc. (“PBAS”) is an independent third-party administrator to pension and benefit plans, specializing in multi-employer trusts, with 150+ employees in seven offices across Canada serving over one million plan members and beneficiaries. PBAS provides a competitive compensation and benefits package, a flexible, team-oriented environment, and is committed to fostering a diverse, equitable, and inclusive workplace.

**Team Responsibilities**:

- Review dental pre-determinations and determine those that need to be reviewed by the Dental Consultant.
- Process claims while serving as the primary point of contact for member & staff inquiries related to pre-determination requests.
- Act as the main resource for internal dental inquiries for all branch offices, offering expert-level support and guidance within area of specialization.
- Lead client onboarding processes.
- Liaise with external dental consultants by coordinating communications and collecting required documentation for case reviews.
- Provide strategic recommendations to streamline workflows and reduce the number of claims needing dental consultant review.
- Support the Manager and Team Lead in training staff in specific processes and departmental workflows.
- Participate in benefit booklet review.
- Monitor and track the progress of work being performed, making workflow adjustments when needed.
- Assist team members with escalated issues and refer unresolved matters to the Team Lead or Manager as appropriate.
- Review of monthly invoices submitted by the external dental consultant.
- Perform other duties and contribute to special projects as assigned.

**Skills**
- Minimum of 5 years of experience in dental claims processing or dental benefits administration.
- Strong working knowledge of dental terminology, procedure codes, fee guides, benefit booklets and the new PBAS Portal.
- Dental office experience is an asset.
- Demonstrated analytical and problem-solving skills, with the ability to assess complex dental cases and recommend appropriate actions.
- Ability to manage multiple tasks, prioritize workload, and adapt to changing priorities in a fast-paced environment.
- Detail-oriented with a high degree of accuracy and accountability.
- Excellent written and verbal communication skills, with the ability to explain complex dental benefit issues to both internal and external stakeholders.
- Proficiency with group benefits administration systems and Microsoft Office, with intermediate-level skills in Word and Excel.

**Job Types**: Full-time, Permanent

**Benefits**:

- Company pension
- Dental care
- Disability insurance
- Employee assistance program
- Extended health care
- Life insurance
- On-site parking
- Paid time off
- Vision care

Work Location: In person

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