Commercial Dental Associate, DentaQuest

Job 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.

Denta Quest 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.

The Commercial Dental Representative will handle customer service inquiries via phone and some dental claims processing. The ideal candidate will have excellent communication skills, a strong comprehension of dental insurance, and the ability to manage both customer interactions and administrative tasks efficiently.

• Serve as the primary point of contact for members, dental offices, and providers via phone, email, or online inquiries.
• Answer questions related to dental benefits, claims status, and general dental plan inquiries.
• Resolve issues or concerns regarding claims, billing, coverage, and other customer service‑related matters.
• Document all customer interactions accurately in the system.
• Provide clear explanations of policies, procedures, and benefits to callers.
• Maintain a high level of professionalism, empathy, and customer service during all interactions.
• Verify dental benefits and eligibility for members and providers.
• Communicate claim status and outcomes to providers and members, including providing detailed explanations for claim outcomes.

• May include processing some dental claims pend types in accordance with company policies and procedures.
• May perform claim adjustments on a defined set of claim types.
• Ensure claims are accurate, complete, and comply with relevant guidelines and regulations.
• Resolve any discrepancies or issues related to claim denials or rejections. This may include modifying or adjusting some claim types.
• Maintain confidentiality and adhere to HIPAA guidelines when processing claims and handling confidential information.

• High school diploma or equivalent.
• Previous experience in a call center, customer service, or claims processing environment (preferred).
• Knowledge of dental insurance plans, benefits, and terminology (strongly preferred).
• Excellent verbal and written communication skills.
• Strong problem‑solving abilities and attention to detail.
• Ability to manage time effectively and handle multiple tasks simultaneously.
• Proficiency in Microsoft Office Suite (Word, Excel, Outlook) and experience with CRM systems or claims processing software.
• Ability to maintain professionalism in a fast‑paced, customer‑focused environment.
• Strong social and communication skills to build rapport with customers and providers.
• Ability to work without supervision as well as part of a team.
• Knowledge of dental terminology and procedures is highly beneficial.
• Excellent organizational and multitasking abilities.
• Ability to work under pressure and meet deadlines while maintaining high‑quality work.

Salary Range: $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.

N…