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Dental Claim Specialist || Immediate Joiner

5 - 10 years

9 - 11 Lacs

Posted:2 days ago| Platform: Naukri logo

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Work Mode

Work from Office

Job Type

Full Time

Job Description

Role & responsibilities

Shift timings (01:30 PM - 10 PM )

Hybrid Mode- Work from office.

Looking for Immediate joiner.

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

Key Qualifications and experience:

  • 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
  • Decision-maker
  • Open to retroaction and giving feedback
  • Bilingualism (French and English, verbal and written) nice to have

Your scope of work / key responsibilities:

  • 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

V.vaibhav@sunlife.com

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Sun Life Global Solutions
Sun Life Global Solutions

Financial Services

Toronto

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