Iowa Provider Enroll & Credentialing Support Specialist, DentaQuest - Reside in Iowa

Overview

Sun Life U.S. is one of the largest providers of employee and government benefits, serving approximately 50 million Americans. 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.

Denta Quest manages dental and vision benefits for more than 33 million Americans, focusing on prevention and value to improve oral health.

Sun Life embraces a hybrid work model balancing in-office collaboration with the flexibility of virtual work in the contiguous states plus AK. This role is based in Iowa.

Provider Enrollment and Credentialing Specialist reviews all aspects of Initial/Re-Apply Credentialing, Re-credentialing, privileging and the onboarding process for all incoming providers. Primary responsibilities include verifying credentialing criteria for practitioners applying to the network and following up as needed to obtain information.

• Verify potential and existing provider licensure, NPI, insurance, CDS, DEA certificate, education, hospital privileges, board certification.
• Contract validation: review contract and application for completeness.
• Review National Practitioner Data Bank for adverse charges pending or filed against provider.
• Review federal and/or state OIG and SAM reports for exclusion from Medicaid or Medicare.
• Review state Medicare OPT Out report for exclusion from the Medicare program.
• Monitor and report 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 provider information in Windward and Cactus.
• Ensure credentialing file is in order with any issues flagged for committee.
• Meet required turnaround time and accuracy rate.
• Assist with other duties as assigned and with department process improvements.
• Support NCQA certification activities.
• Represent Denta Quest professionally with internal and external requestors; maintain confidentiality of credentialing information.
• Other duties as needed or required.

• High School Diploma or equivalent.
• 1 year job-related experience.
• Experience with files or data collection/coordination preferred.
• Knowledge of dental terminology preferred.
• Good interpersonal and communication skills (oral and written).
• Ability to work independently and learn new software quickly.
• Efficient PC skills (Word, Excel, Outlook, workflow software, time-tracking systems).
• Ability to prioritize and organize multiple tasks; remain organized with interruptions.
• Customer service and problem-resolution skills.
• Ability to navigate credentialing websites and adapt to changing environments.
• Ability to work in excess of 40 hours per week and attend additional training as needed.
• Manual dexterity and sitting as required.

Salary Range: $40,600 - $54,800

We are committed to pay transparency and equity. Your actual base salary will be determined based on skills, qualifications, experience, education, and geographic location. This position is eligible for a discretionary annual incentive award based on individual and company performance.

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We are committed to fostering an inclusive environment. We encourage applications from qualified individuals from all backgrounds.

Life is brighter when you work at Sun Life. We offer comprehensive benefits, including vacation and sick time, paid family/parental/adoption leave, medical coverage, life and AD&D insurance, disability programs, a 401(k) match, stock purchase options, and a flexible, inclusive work environment. We are recognized as a top employer in our communities.

We will make reasonable accommodations to known physical or mental limitations of otherwise-qualified individuals with disabilities or special disabled veterans, unless the accommodation would impose an undue hardship. Please email  to request an accommodation. For applicants residing in California, read the California Privacy Policy and Notice. We do not administer lie detector tests as a condition of employment. Sun Life will consider qualified applicants including those with criminal histories, in accordance with state and local laws and fair chance ordinances.

All qualified applicants will receive consideration without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.

Job Category:
Customer Service / Operations

Posting End Date: 12/02/2026