Full-time, permanent position

Hybrid working environment, easily accessible downtown Toronto location Competitive salary package with benefits package that include a Health Spending account ONE YEAR MATERNITY LEAVE COVERAGE

We’re Raise, and we’ve joined forces with our client Accerta, who is seeking to hire a Dental Program Specialist.

AccertaClaim Servicorp Inc, is a B Corp certified social enterprise enabling healthcare equality for all. As a social enterprise, they manage dental, vision, drug, and healthcare benefits programs exclusively for government and social services agencies in Canada. Their targeted experience and innovative technology provide cost savings, reliable service, process continuity, and accurate, insightful data that enables governments to make informed strategic decisions, reducing stress on the healthcare system through streamlined administration.

As the Dental Program Specialist, you will play a key role in the successful implementation, configuration and evolution of the new claims adjudication platform specific to dental benefits. You will bring your dental domain expertise and deeply understand policies, fee guides, and clinical coding standards.

Details

This is a full-time, permanent position offering a hybrid work model that blends remote work with planned in-office days. You will be required to visit the Toronto office sporadically.

Primary Accountabilities

Dental Domain Expertise & Policy Application: Serve as the internal subject matter expert for dental program rules, fee guide structures, and policy alignment. This includes collaborating with the Product Director and product team to define and document adjudication logic for dental benefits (e.g., codes, frequencies, limitations, exclusions, co-payments), and interpreting/applying changes to provincial fee guides, standards, and funding program requirements within the adjudication platform. Solution Design & Requirements Translation: Assist in the translation of complex dental policy and business requirements into clear user stories or technical specifications that inform platform configuration and development. Quality Assurance & Validation: 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. This also involves engaging with clients, government stakeholders, and internal partners to rigorously validate rule configurations and ensure platform outputs meet dental program expectations. Issue Resolution & Risk Management: 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. Operational Readiness & Post-Launch Support: 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. Performance Monitoring & Continuous Improvement: 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. Knowledge Management & Communication: 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. Regulatory & Industry Foresight: Stay informed of industry developments, evolving regulatory changes, and emerging trends in dental benefits to ensure the platform remains compliant, competitive, and future-ready.

Experience

Required Skills and Qualifications

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

Skills And Competencies

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.

Looking for Meaningful Work? We can help.

Raise is an established hiring firm with over 65 years of experience. We believe strongly in making the world a better place through work, which is why we’re a certified B Corporation and donate 10% of our profits to charity.

We strive to build teams that reflect the diversity of the communities we work in. We encourage all qualified applicants to apply, including people from traditionally underrepresented groups such as women, visible minorities, Indigenous peoples, people identifying as LGBTQ2SI, veterans, and people with visible/nonvisible disabilities.

We have a dedicated webpage for accommodations where you can learn more about what we offer, and request accommodation: https://raise.jobs/accommodations/

In order to submit candidates for roles, our clients will sometimes require personal information to confirm the identity of applicants and their legal status to work. Raise will never ask you for personal or banking information unless you have been selected for a job. If you are ever unsure about the legitimacy of this or another job posting by Raise (or have any other questions), please contact us at +1 800-567-9675 or hello@raiserecruiting.com

#IMWM,