Sun Life · 1 week ago
Iowa Provider Enroll & Credentialing Support Specialist, DentaQuest - Must Reside in Iowa
United States
Full-time
Remote
Entry Level
$41K/yr - $55K/yr
1+ years expSun Life is one of the largest providers of employee and government benefits in the U.S., helping millions access necessary care. The Provider Enrollment and Credentialing Specialist will manage the credentialing process for incoming providers, ensuring all criteria are met and maintaining accurate records.
FinanceFinancial ServicesInsurance
Responsibilities
Verify potential and existing provider’s licensure, NPI, insurance, CDS, DEA certificate, education, hospital privileges, board certification
Contract Validation: Review contract and application for completeness
Review National Practitioners Data Bank for adverse charges pending or filed against Provider
Review federal and/ or state OIG and SAM report for exclusion from the Medicaid or Medicare program
Review state Medicare OPT Out report for exclusion from the Medicare program
Monitors and reports provider complaints and utilization management reports
Assist with scheduling site reviews
Enroll the provider into payment system – Windward
Enter all provider information into credentialing database – Cactus
Maintain the integrity of the provider information in Windward and Cactus
Ensures credentialing file is in order with any issues flagged for committee
Meet required turnaround time and accuracy rate
Assist with other duties as assigned
Assist management in the implementation of department process improvements
Assist with the ongoing NCQA certification activities
Represent DentaQuest in a professional manner at all times while communicating with internal and external requestors
Maintains confidentiality of the credentialing information
Other duties as needed or required
Qualification
Required
Candidate must reside in the state of Iowa
High School Diploma or equivalent
1 year job related experience
Good interpersonal skills
Ability to work independently
Excellent oral and written communication skills
Efficient PC skills (Word, Excel, Outlook, Work Flow Software, Time Tracking Systems)
Ability to learn new software programs quickly
Ability to prioritize and organize multiple tasks
Ability to remain organized with multiple interruptions
Good customer service and problem resolution skills
Ability to navigate websites needed for credentialing purposes
Ability to adapt to a constantly changing environment
Ability to work in excess of 40 hours in a week
Required to attend additional training as requested/deemed necessary
Incumbent must be able to communicate effectively
Manual dexterity and sitting is required in carrying out position duties
Preferred
Previous experience working with files or the collection and coordination of data
Knowledge of Dental terminology
Benefits
Generous vacation and sick time
Market-leading paid family, parental and adoption leave
Medical coverage
Company paid life and AD&D insurance
Disability programs
Partially paid sabbatical program
401(k) employer match
Stock purchase options
Employer-funded retirement account
Company
Sun Life
Sun Life is a leading financial services organization dedicated to helping people achieve lifetime financial security and live healthier lives.
10001+ employees
Funding
Current Stage
Public CompanyTotal Funding
$1.05B2024-05-13Post Ipo Debt· $548.79M
2023-07-04Post Ipo Debt· $500M
2000-03-24IPO
Leadership Team
Kevin Strain
President & CEO
Luc Nhon Ly
Chief Executive Officer
Recent News
2025-12-02
MarketScreener
2025-12-02
South China Morning Post
2025-11-27
Company data provided by crunchbase