Claim Processing Representative, DentaQuest

DentaQuest; Milwaukee (WI); Hybrid; USD 39,000 - 54,000; Full time

Job summary

An established industry player is seeking a Claims Processing Representative to join their dynamic team. In this role, you will be responsible for processing claims with exceptional accuracy while adhering to workflow requirements. The ideal candidate will possess strong mathematical skills, attention to detail, and the ability to work collaboratively in a hybrid environment. This position offers an exciting opportunity to contribute to a company dedicated to improving oral health for millions. With a commitment to employee well-being and a supportive work culture, this is a chance to thrive in your career while making a meaningful impact.

Benefits

Generous Vacation and Sick Time

Paid Family and Parental Leave

401(k) Employer Match

Stock Purchase Options

Employer-Funded Retirement Account

Partially Paid Sabbatical Program

Qualifications

• Strong math competency and attention to detail are essential.
• Ability to efficiently operate a computer and follow instructions.

Responsibilities

• Process entry-level and intermediate claim queues with high accuracy.
• Serve as backup for claims administration and call center during peak times.

Skills

Mathematical Competency

Communication Skills

Attention to Detail

Self-Motivation

Education

Associate Degree

2 Years Experience in Business Environment

Tools

Microsoft Office (Word, Excel, Outlook)

Job description

5 days ago Be among the first 25 applicants

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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.

Job Description:

Location: Sun Life embraces a hybrid work model that balances in-office collaboration with the flexibility of virtual work.

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. This role focused on commerical business.

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:

• Associate 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.
  
  

Salary: 39,300 - 53,100

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.

Not ready to apply yet but want to stay in touch? Join our talent community to stay connected until the time is right for you!

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 [e-mail] 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.

Job Category:

Claims - Health & Dental

Posting End Date:

15/05/2025

Seniority level

• Seniority level

  Not Applicable

Employment type

• Employment type

  Full-time

Job function

• Job function

  Finance and Sales

• Industries

  Financial Services and Insurance

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