Sun Life Financial

• Build technical skills and learn insurance concepts • Gain understanding of product features and contracts • Provide meaningful contributions to teams by completing actuarial projects

• Review claims and interpret contracts • Disperse reimbursement and ensure claims documentation is complete • Provide customer service and manage financial risk of claims block • Develop and implement a plan of action for accepted claims

RCM Insurance AR and Posting Specialist (Dental Billing) locations U.S. Telecommuters time type Full time job requisition id JR00119650 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.   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.  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 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. Job Category: Finance

Senior Underwriter, Stop Loss Apply locations U.S. Employees (Remote) Baltimore, Maryland Hartford, Connecticut Portland, ME U.S. Telecommuters View Fewer Locations locations Kansas City, Missouri Wellesley Hills, Massachusetts Milwaukee, Wisconsin Nashville, Tennessee time type Full time posted on Posted 13 Days Ago job requisition id JR00121798 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. Job Description: The opportunity: Sun Life is seeking a passionate individual who can exercise independent and creative thinking to achieve defined sales and profitability goals to join us in a Senior Underwriter, Stop Loss role. As a member of the Stop Loss Underwriting Team, you will be part of the leading direct provider of stop loss insurance in the United States. This is a great opportunity to join the Sun Life Stop Loss Underwriting Team! How you will contribute: - Evaluate, price, and propose rate and strategy on Stop Loss prospects, including specific and aggregate benefits - Investigate case-level information to properly assess risk and provide client centric solutions - Operate within established underwriting guidelines and profitability targets - Manage the sold case process including review of required sold case paperwork, case contingencies, and final risk assessment - Manage assigned workload to meet productivity and time service standards - Demonstrate strong decision-making skills, while recognizing and accounting for anticipated consequences - Identify and assess the impact of emerging market conditions - Act as a resource for other underwriters and sales team members - Partner with regional sales team to implement successful strategies for profitable growth - Display teamwork and collaboration with internal and external partners - Support the identification and development of best practices, workflows and procedures What you will bring with you: - Ability to work with a diverse range of people - 4+ years of Medical Stop Loss underwriting experience is required (Self of fully insured) - 5-7+ years of other medical underwriting experience will be considered - Proficient knowledge of Microsoft Excel - Strong math, communication, negotiation, and analytical skills - Demonstrates multi-tasking ability - Must be detail oriented, well organized and have the ability to manage a high-volume workload with multiple priorities - Continuous improvement mindset Salary Range: $85,200-$127,800

• Manage and Guide provider engagement staff • Ensure provider engagement staff recruits providers within cost and access goals • Authorize and negotiate special deals • Develop strategic action plan to address network gaps • Develop provider education curriculum and approach • Cover more markets or highly complex markets • Organize amendment and recruitment projects • Develop project plans, internal/external reports, and ensure deliverables are met • Identify and coordinate implementation of quality/cost improvements • Manage reporting process to identify and modify provider outliers • Provide cross-market aid as needed • Analyze and monitor provider performance reports • Participate in and often present during client, organized dentistry and key stakeholder meetings/events • Identify continuous improvement opportunities • Manage CAP office performance • Coordinate and implement appropriate performance management strategies for team members to include: Assist in the hiring process, including interviewing candidates. Assist, train and motivate team members. Evaluate and measure effectiveness of team members. Assist in preparation of performance and wage evaluations in accordance with company policy. Manages attendance and company-approved time off for team members. • Participate in the drive and implementation of Performance Improvement Plans and performance management initiatives. • Other duties as assigned

• Review and follow up on outstanding claims • Contact insurance companies, payers, and patients to resolve discrepancies • Investigate claim denials and follow up with payers • Oversee billing activities ensuring accurate submission of claims • Identify, investigate, and resolve claim rejections • Provide support and respond to inquiries regarding billing issues • Manage follow-up on outstanding accounts receivable • Accurately post payments and adjustments to accounts • Identify and resolve credit balances on accounts • Assist in identifying and implementing process improvements

• Provide in depth technical and operational expertise of benefits technology platform • Advise, guide, and support Sun Life’s EBRs & Client Managers to enable the sale of digital as a product • Support the roll-out of new benefits technology programs and relationship • Develop business relationships with technology centers & experts with our top national and regional brokers to communicate and align digital strategies • Promote Sun Life's capabilities and positioning of our BenTech value proposition • Maintain awareness of competitive issues, trends, and opportunities in the marketplace • Identify training opportunities and provide input into the development of training programs • Act as a liaison with all internal Sun Life’s departments (e.g., Product, Distribution, Underwriting, Customer Service Delivery, Marketing, & Training) to ensure end to end process success, provide subject matter expertise, and develop recommendations to improve integrated service models with third party benefits technology

Title: Insurance AR and Posting Specialist Location: Hartford United States Full time 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. Job Description: Sun Life embraces a hybrid work model that balances in-office collaboration with the flexibility of virtual work. Our team members and leaders are expected to foster connection and teamwork by being present in the office at least 2 days per week. 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. 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! 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. 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: Finance

Title: Senior Auditor Location: Wellesley Hills, Massachusetts Hartford, CT Office Portland, ME Kansas City, MO Office United States 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. Visit our website to discover how Sun Life is making life brighter for our customers, partners and communities. Job Description: Sun Life embraces a hybrid work model that balances in-office collaboration with the flexibility of virtual work. 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: Internal Audit contributes to the long-term competitive advantage of the company through the execution of high quality and efficient audit services which help our clients proactively manage risks in their business. The candidate is responsible for assisting the audit team with the planning, fieldwork and reporting phases of audit engagements and projects. The role includes significant client interaction in order to evaluate the adequacy and effectiveness of internal controls and the efficiency of operations. The role is also responsible for contributing to a proactive, high performance team environment. How you will contribute: - Prepares for meetings with clients for the purpose of audit planning, fieldwork and reporting, including presenting audit findings and recommendations, and documenting the results of these meetings. - Works under the guidance of Audit Manager/Senior Audit Manager to develop business understanding, business objectives, risks, performance metrics, key controls, and testing strategies for each audit engagement assigned. - Supports audit team monitoring of audit project progress and status. - Prepares identified issues to ensure they are clearly understood, documented, and that the process owner/unit management provides corrective actions. - Assists with the preparation of internal audit reports of findings and recommendations for delivery to management. - Identifies opportunities to build, leverage and execute data analytics within audit. - Designs and implements data analytics. - Monitors audit findings to ensure effective resolution and perform testing to ensure findings have been properly remediated. - Contributes to preparation of internal audit management reports. - Actively builds and manages relationships with business partners. What you will bring with you: - Robust knowledge of risks and controls - Data analytics experience preferred with tools like ACL/Arbutus, Dataiku, Tableau and/or any other analytics tools - Insurance industry background preferred (actuarial, underwriting, claims, insurance operations and related products) - Proven ability to perform assigned tasks for multiple projects simultaneously - Proactive, energetic self-starter with the ability to meet deadlines - Excellent interpersonal skills: ability to collaborate, influence and network effectively in a team environment - Understand how technologies and applications support business processing and execute test plans for IT and application controls - Ability to communicate effectively, both verbally and in written form, with technical and nontechnical audiences - Strong analytical, critical thinking and problem-solving abilities - Ability to devise innovative solutions in a dynamic business environment - Internal Audit experience and/or proficiency with auditing large projects preferred Salary Range: $60,200 - $90,300 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 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.

• Provides operational guidance in the effective delivery of services to clients, members, and stakeholders • Collaborates on service delivery, corporate and division strategic priorities and compliance with implementation of all regulatory requirements • Reports to the director within the Compliance department • Handles contractual and regulatory quality and compliance for California government program clients • Serves as the compliance subject matter expert (SME) to the operational leads in implementation of compliant processes • Administers an organizational quality management system and monitors progress against strategic and contractual quality-related goals • Develops training programs to ensure compliance with legal and contractual obligations • Coordinates and communicates all compliance activities and programs to internal departments and external clients • Maintains up-to-date knowledge of developments in all legislative and regulatory implications for DentaQuest California • Oversees the operational aspects of California compliance and Quality, providing audit and monitoring oversight