Information Technology - Dental Specialist

Accerta • Toronto, ON

1d • CA$70,000 - CA$85,000 • Hybrid

About The Position

The Dental Program Specialist plays a key role in the successful implementation, configuration, and evolution of the new claims adjudication platform specific to dental benefits. This position brings dental domain expertise and a deep understanding of policy, fee guides, and clinical coding standards to ensure accurate adjudication logic, compliance with provincial and federal standards, and alignment with stakeholder needs. The specialist will act as the subject matter expert for dental program administration, contributing to benefit rule design, user acceptance testing, issue resolution, and business readiness activities. The individual will work closely with product owners, business analysts, QA, development teams, and external partners to shape how dental claims are adjudicated and managed within the platform.

Requirements

• 5+ years of experience in dental benefits administration, claims adjudication, or program delivery.
• Familiarity with provincial dental fee guides, dental coding systems (e.g., CDAnet), and clinical dental terminology.
• Experience supporting or working with adjudication systems, with an emphasis on logic rules, workflows, and benefit structures.
• Strong analytical skills and attention to detail in interpreting policy and translating into technical/system requirements.
• Excellent written and verbal communication skills; ability to interface with both technical teams and business stakeholders.
• Comfortable working in agile or iterative environments, contributing to requirements definition, backlog grooming, and sprint reviews.
• Demonstrated ability to manage competing priorities and timelines in a collaborative, cross-functional setting.

Nice To Haves

• Previous involvement in digital transformation or system implementation projects is an asset.

Responsibilities

• Serve as the internal subject matter expert for dental program rules, fee guide structures, and policy alignment.
• Collaborate with the Product Director and product team to define and document adjudication logic for dental benefits (e.g., codes, frequencies, limitations, exclusions, co-payments).
• Interpret and apply changes to provincial fee guides, standards, and funding program requirements within the adjudication platform.
• Assist in the translation of complex dental policy and business requirements into clear user stories or technical specifications that inform platform configuration and development.
• Support the entire testing lifecycle, including the creation of detailed test scenarios and execution of User Acceptance Testing (UAT) specifically related to dental workflows and claims outcomes.
• Engage with clients, government stakeholders, and internal partners to rigorously validate rule configurations and ensure platform outputs meet dental program expectations.
• Participate actively in issue triage and resolution during both test phases and post-implementation, providing essential business context and recommendations.
• Proactively identify and assess potential risks and dependencies related to dental program rules, regulatory changes, and complex adjudication scenarios, proposing effective mitigation strategies to ensure platform stability and compliance.
• Work closely with internal stakeholders to assess program readiness, support the development of training materials and documentation, and provide ongoing subject-matter support post-launch.
• Continuously monitor and analyze the operational performance of the claims adjudication platform's dental logic post-launch, identifying opportunities for optimization and efficiency gains in adjudication accuracy and speed.
• Maintain comprehensive and up-to-date documentation of dental program rules, adjudication logic, system configurations, and related processes to ensure accurate knowledge transfer and operational continuity.
• Proactively communicate updates, impacts, and strategic direction related to dental benefits and adjudication logic to all relevant cross-functional teams and stakeholders, ensuring consistent understanding and alignment.
• Stay informed of industry developments, evolving regulatory changes, and emerging trends in dental benefits to ensure the platform remains compliant, competitive, and future-ready.

Benefits

• Contract employee plan coverage begins on the employee's first day.
• Growth Opportunities: in a company that promotes from within.
• Home Office Stipend: A one-time payment of $750 included in the employee's first paycheck.
• Employee Referral Reward: Employees can earn a $1,500 reward for successful referrals of other employees.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed