WHO WE ARE

AccertaClaim Servicorp Inc. (ACSI) and its subsidiary, Accerta Services Inc. (ASI), also known as Accerta.

Accerta 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 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.

Accerta is a Certified B Corporation which is a testament to the values we’ve built our business on: 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!

ABOUT THIS OPPORTUNITY

The successful candidate 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.

WHAT WE OFFER

• Group Benefits: Coverage begins on the employee’s first day and includes a Health Care Spending Account and Personal Spending Account (depending on allocation).
• Pension Plan: Eligibility starts on the employee’s first day, and a 5% employee contribution is matched by a 5% employer contribution.
• Performance-based incentive programs: Opportunities to increase your earnings.
• Growth opportunities in a company that promotes from within.
• Volunteering: Time off to volunteer within our community
• Hybrid: working environment with a laptop and two monitors.
• Home Office Stipend: A one-time payment of $750 included in the employee’s first paycheck.
• Mental Health Support: Access to Mental Health on Demand for employees and their dependents.
• Member Assistance Program: Includes Employee Assistance Program services.
• Community Volunteering: Up to 8 hours of paid time off annually to volunteer in your community.
• Financial Wellness: Opportunities to contribute to non-matching GRRSPs, TFSAs, and FHSAs, along with financial information sessions.
• Education Reimbursement: Tuition reimbursement for post-graduate courses, upon prior approval.
• Employee Referral Reward: Employees can earn a $1,000 reward for successful referrals.

FLEXIBLE WORK ARRANGEMENT:

We support a hybrid approach, which will give everyone the best of both worlds – a mix of home and in-office workdays.  Hybrid schedules will be determined in partnership between individuals, managers, and the team. 

HOW TO APPLY

We accept applications submitted via email to kmcbride@accerta.ca. Please note that we use AI tools to support and enhance our recruitment process. Rest assured that your application will be reviewed thoroughly by our hiring team.

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.  Accommodations are available on request for candidates taking part in all aspects of the selection process.

To request accommodation, please contact accessibility@accerta.ca.

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