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.
Job Description:
FULLY REMOTE OPPORTUNITY
The Insurance A/R & Posting Specialists are responsible for a variety of tasks within the Accounts Receivable (AR) and Revenue Cycle Management (RCM) processes. This includes managing rejections, billing, help desk inquiries, AR follow-up, posting payments, and credit balances. These roles will work within a pod structure, where staff will be assigned specific tasks and rotate through the pods at different times. Cross-training is a key part of this structure, and team members will be responsible for filling in for others as needed, ensuring continuity and consistency of the work.
How you will contribute:
Claims Follow-Up: Review and follow up on outstanding claims to ensure timely reimbursement. Contact insurance companies, payers, and patients to resolve any discrepancies, denials, or underpayments.
Denial Management: Investigate claim denials, determine reasons for non-payment, and follow up with the payer to resolve and appeal when necessary.
Billing: Oversee billing activities, ensuring accurate and timely submission of claims to payers, and address any billing discrepancies.
Rejections: Identify, investigate, and resolve claim rejections promptly to ensure the timely processing of payments.
Help Desk: Provide support and respond to internal and external inquiries regarding billing issues, claim statuses, and account discrepancies.
AR Follow-Up: Manage follow-up on outstanding accounts receivable, ensuring timely resolution of overdue claims and facilitating effective communication with payers.
Posting: Accurately post payments and adjustments to patient accounts and insurance claims.
Credit Balances: Identify and resolve credit balances on accounts, ensuring they are handled promptly and according to company policy.
Cross-Training: Willingness to cross-train in all functions of RCM, including but not limited to billing, refunds, collections, and other processes, to support team flexibility and efficiency.
Process Improvement: Assist in identifying and implementing process improvements to streamline the AR and billing functions.
Collaboration: Work closely with other members of the RCM team to ensure timely and effective resolution of claims, share knowledge on payer issues, and improve overall processes.
What you will bring with you:
High school diploma or equivalent
Minimum of 3 years of experience in accounts receivable, dental billing, or a related field is required
Experience in a dental or healthcare environment, ideally within a Dental Service Organization (DSO) or similar multi-location setting.
Strong knowledge of insurance billing, payment procedures, and AR processes.
Knowledge of payer guidelines and claims appeals processes.
Familiarity with dental practice management systems, such as Dentrix or similar PMS platforms.
Ability to navigate payer portals, insurance company websites, and databases.
Excellent communication and negotiation skills to resolve issues with insurance payers.
Strong attention to detail and organizational skills.
$43,100 - $58,200
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.
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