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 welcome applicants from anywhere in the U.S.

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 Licensing & Credentialing Specialist is responsible for all aspects of the Initial/ Re-Apply Credentialing, Re-Credentialing, privileging and overseeing the onboarding process for all incoming and existing providers. Primary responsibilities include verifying all licenses and certifications for providers to ensure all required licenses and certifications are active and in good standing, credentialing requirements are met, including follow up with practitioners as needed to obtain information.

How you will contribute:

• Verify potential and existing provider’s licensure, NPI, insurance, CDS, DEA certificate, education, hospital privileges, board certification.

• Accurately draft and send all required enrollment applications for new providers relevant to the DQCG dental and optical center(s)

• Review all returned applications received and completed by the dentist for accuracy and verify all applications were completed and answered appropriately and all required signature places were signed by the provider.

• Notify Manager, Licensing & Credentialing immediately if/when any attestation questions were answered affirmative by the provider(s).

• Ensure providers are credentialed and linked properly to all dental centers located within the state they are hired to work.

• Ensure all providers’ licensure and certification credentials remain active according to state and/or federal guidelines.

• Review and submit all licensure and certification credentials and payer re-credentialing applications to licensure agencies, prior to the current term dates, to ensure all providers’ credentials remain active with no break in coverage.

• Documents, tracks and follow-up on all re-credentialing applications submitted until they are approved and notify Manager, Licensing and Credentialing when approved.

• Maintain the integrity and confidentiality of the provider and credentialing information.

• Maintain, update, and add provider information and approvals in credentialing software

• Actively participate and collaborate with teammates in process improvement projects both internally and externally.

• Represent Sun Life Care Group in a professional manner at all times while communicating with internal and external requestors.

• Ability to independently, accurately, and timely resolve credentialing issues presented by external or internal customers.

• Assist with other duties as assigned.

What you will bring with you:

Required:

• 1-2 years experience in licensing and credentialing or related field

• Experience in state licensure requirements for dentists and affiliated healthcare professions, as well as insurance credentialing required.

• Demonstrates self-motivation by taking the initiative to learn, take on additional responsibilities and make process improvement recommendations.

Preferred:

• Bachelor’s Degree

• Knowledge of Dental terminology preferred.

• Knowledge of credentialing criteria, NCQA, CMS and or Managed Care requirements and processes.

• Experience with effectively communicating with Dentists, Optometrists and/or healthcare professionals.

Competencies:

• Requires strong attention to detail, recordkeeping, communication, and critical thinking

• Ability to work independently, and provide assistance to other team members.

• Excellent oral and written communication skills.

• Ability to learn new software programs quickly.

• Systematic, detail oriented and process driven.

• Strong teamwork orientation

• Ability to navigate websites needed for credentialing purposes.

• Excellent analytical ability.

• Ability to adapt to a constantly changing environment.

• Ability to prioritize and organize multiple tasks with multiple interruptions

• Excellent customer service and problem resolution skills.

• Ability to use good judgment and make quick independent decisions.

Do you see yourself in this role even if you haven’t checked all the boxes above? We welcome all talented candidates and are committed to a culture that represents diversity in all forms. If you think you might thrive in this setting, we would love to hear from you.

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!

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.

Salary Range: $52,500 - $70,900

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.

Sun Life Financial is a leading provider of group insurance benefits in the U.S., helping people protect what they love about their lives. More than just a name, Sun Life symbolizes our brand promise of making life brighter -for our customers, partners, and communities. Join our talented, diverse workforce and launch a rewarding career. Visit us at www.sunlife.com/us to learn more.

At Sun Life we strive to create a flexible work environment where our employees are empowered to do their best work. Several flexible work options are available and can be discussed throughout the selection process depending on the role requirements and individual needs.

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Our Affirmative Action Program affirms our commitment to make reasonable accommodation to the known physical or mental limitation 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 [email protected] to request an accommodation.

At Sun Life we strive to create a flexible work environment where our employees are empowered to do their best work. Several flexible work options are available and can be discussed throughout the selection process depending on the role requirements and individual needs.

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