WHO WE ARE
AccertaClaim Servicorp Inc. (ACSI) and its subsidiary, Accerta Services Inc. (ASI), both known as Accerta, which is a is a social enterprise, that manages dental, vision, drug, and healthcare benefits programs exclusively for government and social services agencies in Canada. Our targeted experience and innovative technology provide reliable service, process continuity, cost savings, as well as accurate and insightful data that enables governments to make informed strategic decisions, reducing stress on the healthcare system through streamlined administration.
Accerta is a Certified B Corporation which is a testament to the values on which we’ve built our business: serving our customers, caring for our employees, and supporting our community and the environment. Being part of the B Corp movement means we’re committed to continual improvement and making business a force for good. Thank you to our team and stakeholders who have helped us achieve this significant milestone!
JOB TITLE: Dental Program Specialist
EMPLOYMENT TYPE: Fixed Term Contract 12 months, Hybrid (maternity leave coverage)
ABOUT THIS OPPORTUNITY
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.
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.
QUALIFICATIONS
Experience:
- 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.
ANNUAL SALARY: $70,000 – 85,000
WHAT WE OFFER
- Group 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.
FLEXIBLE WORK ARRANGEMENT:
Employees are expected to work on-site at least once per month at our Toronto office (4 New Street, Toronto, ON), with additional in-office days as required based on business needs. Hybrid schedules are determined collaboratively between employees, managers, and teams.
HOW TO APPLY
We accept applications submitted via our Dayforce Portal - Click this link to apply. Please note that we use AI tools to support and enhance our recruitment process, including scribing tools during the interview. Artificial intelligence (AI), however, is not used to screen candidates.
Rest assured that your application will be reviewed thoroughly by our hiring team.
RECRUITMENT NOTICE
- Accerta will only contact candidates using an @accerta.ca email address and will never request payment or personal financial information during the hiring process.
- If you are interested in a role posted on our website, please follow the application instructions outlined on the postings on the Accerta careers page.
- If you receive an email claiming to be from Accerta that seems unexpected or suspicious, please verify by contact [email protected]
INCLUSION AND EQUAL OPPORTUNITY EMPLOYMENT
Accerta is an equal opportunity employer and committed to fostering diversity and inclusion in the workplace. We are committed to fair employment practices, and all qualified applicants will receive consideration for employment. We offer accommodation for applicants with disabilities, as required throughout the recruitment process. Reasonable accommodation is also available on request for candidates taking part in all aspects of the selection process.
To request accommodation, please contact
[email protected].
We appreciate your interest in working with us; however, only those applicants selected for interviews will be contacted.
Final candidates for this position may be required to undergo a security screening, including criminal records check, judicial matters check, vulnerable sector screening and employment reference check. To learn more about us please go to: www.accerta.ca.
