Provider Release Analyst, DentaQuest Position Available In Cumberland, Maine

Provider Release Analyst, DentaQuest at Sun Life Financial (U.S.) Services Company, Inc. in South Portland, Maine, 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. 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.

Job Description:

Location:

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 ourClients.

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 challengedbyworking withdynamic colleaguesto find new and innovative ways to make Sun Life the best benefits company in America.

The opportunity:

As a Provider Release Analyst, you will be responsible for the oversight and management of the daily provider claims payment processing for our Dental and Vision Business. This position aids the daily full cycle processing of the claims payments ensuring all financial transactions are completed timely and within our established controls and audit policies. The Analyst works closely with the internal technical team and external vendors to ensure visibility is provided related to data integrity and technical issues that may impact timely payment processing.

How you will contribute:

Manage the daily claims process beginning with the release process which includes cash identification, payment and billing reconciliation, release management and communications internally and externally to our print vendors.
Complete multiple extract uploads to the oracle financial system, successfully creating all financial transactions and ensuring all uploads are validated and reconciled to the source files.
Monitor and track all communications, delays or issues between internal IT teams, vendors, and banks throughout the day to ensure all issues are timely resolved and there is no delay or work stoppage that will impact the ability to meet our deadlines.
Process all EFT and Positive pay files and validate successful receipt of the files with each banking institution; address any issues or missing files.
Manage all failed EFT’s and work with internal Credentialing team to resolve accordingly.
Validate vendor print processing to data source documents to ensure no variances.
Reconciles daily Customer refund or other internal interfaces from other systems
Identifies and tracks all interface exceptions related to Windward claims loads, Customer refunds and daily bank reconciliation files.
Logs and monitors all daily production and/or enhancement tickets submitted for data fixes manage to ensure long term solutions are put in place to eliminate data issues and interface errors.
Performs testing for new project or client implementations along with system upgrades ensuring full end to end testing is performed successfully and timely.
Assist all audit requests What you will bring with you:
Preferably degree in Finance or Accounting or relevant prior experience
Strong attention to detail
Proficient user of Microsoft Excel
Well-developed analytical, problem solving and troubleshooting skills
Excellent Communication skills Do you see yourself in this role even if you haven’t checked all the… For full info follow application link. Sun Life Financial is an equal employment and affirmative action employer. All qualified applicants will receive consideration without regard to race, color, sex, religion, age, national origin, disability, veteran status, sexual orientation, gender identity or expression, marital status, ancestry or citizenship status, genetic information, pregnancy status or any other characteristic protected by law. Sun Life Financial is committed to building a diverse and inclusive company culture. 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.