Description

Sun Life U.S. is one of the largest providers of employee and government benefits, helping approximately 50 million Americans access the care and coverage they need. Through employers, industry partners and government programs, Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation. We have more than 6,400 employees and associates in our partner dental practices and operate nationwide.

Visit our website to discover how Sun Life is making life brighter for our customers, partners and communities.  

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.

 The Opportunity:

We are seeking a highly motivated and detail-oriented Dental Claim and Call Center Agent to join our team. This generalist role will involve handling both customer service inquiries via phone and some dental claims responsibilities. The ideal candidate will have excellent communication skills, a strong understanding of dental insurance, and the ability to manage both customer interactions and administrative tasks efficiently.

How you will contribute:

• Call Center Duties:
  • Serve as the primary point of contact for members, dental offices, and providers via phone, email, or online inquiries.
  • Answer questions related to dental benefits, claims status, and general dental plan inquiries.
  • Resolve issues or concerns regarding claims, billing, coverage, and other customer service-related matters.
  • Document all customer interactions accurately in the system.
  • Provide clear explanations of policies, procedures, and benefits to callers.
  • Maintain a high level of professionalism, empathy, and customer service during all interactions.
  • Verify dental benefits and eligibility for members and providers.
  • Communicate claim status and outcomes to providers and members, including providing detailed explanations for claim outcomes.
• Claim Processing Duties:
  • May include processing some dental claims pend types in accordance with company policies and procedures.
  • May perform claim adjustments on a defined set of claim types
  • Ensure claims are accurate, complete, and comply with relevant guidelines and regulations.
  • Resolve any discrepancies or issues related to claim denials or rejections.  This may include modifying or adjusting some claim types.
  • Maintain confidentiality and adhere to HIPAA guidelines when processing claims and handling sensitive information.

What you will bring with you:

• High school diploma or equivalent
• Previous experience in a call center, customer service, or claims processing environment (preferred).
• Knowledge of dental insurance plans, benefits, and terminology (strongly preferred).
• Excellent verbal and written communication skills.
• Strong problem-solving abilities and attention to detail.
• Ability to manage time effectively and handle multiple tasks simultaneously.
• Proficiency in Microsoft Office Suite (Word, Excel, Outlook) and experience with CRM systems or claims processing software.
• Ability to maintain professionalism in a fast-paced, customer-focused environment.
• Strong interpersonal and communication skills to build rapport with customers and providers.
• Ability to work independently as well as part of a team.
• Knowledge of dental terminology and procedures is highly beneficial.
• Excellent organizational and multitasking abilities.
• Ability to work under pressure and meet deadlines while maintaining high-quality work.

Salary Range: $37,900 - $51,200

At our company, we are committed to pay transparency and equity. The salary range for this role is competitive nationwide, and we strive to ensure that compensation is fair and equitable. Your actual base salary will be determined based on your unique skills, qualifications, experience, education, and geographic location. In addition to your base salary, this position is eligible for a discretionary annual incentive award based on your individual performance as well as the overall performance of the business. We are dedicated to creating a work environment where everyone is rewarded for their contributions.

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We are committed to fostering an inclusive environment where all employees feel they belong, are supported and empowered to thrive.  We are dedicated to building teams with varied experiences, backgrounds, perspectives and ideas that benefit our colleagues, clients, and the communities where we operate.  We encourage applications from qualified individuals from all backgrounds.

Life is brighter when you work at Sun Life

At Sun Life, we prioritize your well-being with comprehensive benefits, including generous vacation and sick time, market-leading paid family, parental and adoption leave, medical coverage, company paid life and AD&D insurance, disability programs and a partially paid sabbatical program.  Plan for your future with our 401(k) employer match, stock purchase options and an employer-funded retirement account.  Enjoy a flexible, inclusive and collaborative work environment that supports career growth.  We're proud to be recognized in our communities as a top employer.  Proudly Great Place to Work® Certified in Canada and the U.S., we've also been recognized as a "Top 10" employer by the Boston Globe's "Top Places to Work" for two years in a row.  Visit our website to learn more about our benefits and recognition within our communities.

We will make reasonable accommodations to the known physical or mental limitations of otherwise-qualified individuals with disabilities or special disabled veterans, unless the accommodation would impose an undue hardship on the operation of our business. Please email thebrightside@sunlife.com to request an accommodation.

For applicants residing in California, please read our employee California Privacy Policy and Notice.

We do not require or administer lie detector tests as a condition of employment or continued employment.

Sun Life will consider for employment all qualified applicants, including those with criminal histories, in a manner consistent with the requirements of applicable state and local laws, including applicable fair chance ordinances.

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.