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Claim Processing Representative, Dentaquest

3 months ago

Wellesley Hills, United States DentaQuest Full time

You 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 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.
- DentaQuest manages dental and vision benefits for more than 33 million Americans. Our outcomes-based, cost-effective solutions are designed for Medicaid and CHIP, Medicare Advantage, small and large businesses, and individuals. With a focus on prevention and value, we aim to make quality care accessible to improve the oral health of all._

**Location**:We support US virtual working arrangements in the contiguous 48 states.

At Sun Life, we look for optimistic people who want to make life brighter for our Clients. We understand the value of diverse cultures, perspectives, and identities, and want you to bring your full and authentic self to work. Every day, you’ll be empowered and challenged by working with dynamic colleagues to find new and innovative ways to make Sun Life the best benefits company in America.

**The opportunity**:
The Claim Processing Representative processes entry-level and intermediate claims with a 99% or greater accuracy rate using the company’s proprietary claim processing software.

**How you will contribute**:

- Consistently process entry level and intermediate claim queues with a 99% or greater accuracy rate.
- Adhere to approved claim workflow requirements to maximize efficiency.
- Serve as backup to Claim Administration team for entry-level adjustments to claims as necessary to meet corporate goals.
- Serve as back up to call center during peak periods by taking provider and member calls to ensure corporate-wide service levels are consistently achieved.
- Successfully complete basic claim-related projects, as assigned.
- Other duties as needed or required.

**What you will bring with you**:

- Associates degree or two years of experience in a business environment.
- Strong math competency.
- Ability to efficiently operate computer.
- Strong interpersonal, written and verbal communication skills.
- Attention to detail, accuracy and organization skills are essential.
- Self-motivation demonstrated by a readiness to learn more and assume new challenges.
- Cooperative, professional, and effective interaction skills with co-workers, business partners, and visitors.
- Ability to work in excess of 40 hours in one week.
- Ability to use Microsoft Office. (Word, Excel and Outlook)
- Understanding of general insurance principles.
- Able to follow verbal and written instructions.
- Ability to read and comprehend at a high school level.
- Required to attend additional training as requested/deemed necessary.

Life is brighter when you work at Sun Life
- Excellent benefits and wellness programs to support the three pillars of your well-being - mental, physical and financial - including generous vacation and sick time, market-leading paid family, parental and adoption leave, a partially-paid sabbatical program, medical plans, company paid life and AD&D insurance as well as disability programs and more
- Retirement and Stock Purchase programs to help build and enhance your future financial security including a 401(k) plan with an employer-paid match as well as an employer-funded retirement account
- A flexible work environment with a friendly, caring, collaborative and inclusive culture
- Great Place to Work® Certified in Canada and the U.S.
- Named as a “Top 10” employer by the Boston Globe's “Top Places to Work” two years running

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

f you are a California resident, the salary range for this position is:
Southern region: $43,900 - 59,300 annually

Central region: $41,700 - 56,300 annually

Northern region: $47,000 - 63,500 annually

If you are a Colorado or Nevada resident, the salary range for this position is $39,700 - 53,600 annually.

If you are a Connecticut or Maryland resident, the salary range for this position is $43,900 - 59,300 annually

If you are Washington or Rhode Island resident, the salary range for this position is $41,700 - 56,300 annually

If you are a New York resident, the salary range for this position is 47,000 - 63,500 annually

We consider various factors in determining actual pay including your skills, qualifications, and experience. In addition to salary, this position is eligible for incentive awards based on individual and business performance as well as a broad