- Reports to
- Manager, Group Dental Claims and Claims Support
- Waterloo, ON
- Job Status
- Permanent, Full Time
Dental Adjudicator Opportunity
As a: Dental Adjudicator with Customer Service
This dental claims adjudication role provides a great opportunity for someone who is looking for a career involving attention to detail, problem solving, and customer service in a dental-related field. The objective of the role is to accurately process complex dental claims and non-standard claim transactions while maintaining published service standards and excellent quality.
- Accurately and timely process Health and Dental claims received within the appropriate guidelines and within published service standards.
- Work with the Special Investigations Unit by identifying suspicious claims and alerting the department to the findings.
- Consistently provide clear and concise communication with all claim decisions both verbally over the phone and in writing with each claim decision.
- Contribute to the continuous improvement of business processes.
- Develop and maintain a solid knowledge of: related legislation and Company practice; of policies currently and previously marketed by the Company.
- When required, provide quality customer service to Policyholders, Group Offices, Head Office staff and Medical Providers, using a thorough knowledge of the claims area; the majority of the time involves handling incoming telephone calls.
- Bilingual in French and English, spoken and written is an asset.
- Dental and Medical terminology and related education. Post-secondary education preferred including dental assistant, pharmacy assistant, massage therapy, medical assistant etc.
- Ability to interpret and apply contract provisions and administrative guidelines to determine eligibility and reasonable and customary charges for medical and dental expenses
- Proven interpersonal skills to manage relationships with internal and external clients.
- Ability to handle high stress levels in a fast paced production environment
- Strong change management skills including Adaptability and Flexibility.
- Ability to work effectively in a team environment
- Excellent verbal and written communication skills
- PC skills – working knowledge of MS office, MS Access, keyboarding
How to Apply
To apply for this position, please email your cover letter, including salary expectations, and resume in one MSWord document to firstname.lastname@example.org
If applying to multiple positions, please apply to each position separately.
At Equitable Life, we are committed to providing equal access to employment opportunities across our organization. Please contact our HR team at email@example.com if you require an accommodation with the application process, including for a request to receive our job postings in an alternative format.