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Insurance Claims Processing Jobs in Ontario (NOW HIRING)

... process. This posting is for an existing vacancy. Zurich Canada uses artificial intelligence ... Insurance claims, fraud, special investigation, or claims analytics experience. * Experience with ...

Salary: $55,000 - $70,000 Property Claims Representative MutualONE Insurance Company Where a shared ... Providing exceptional customer service and support to our members throughout the claims process

Salary: $55,000 - $70,000 Property Claims Representative MutualONE Insurance Company Where a shared ... Providing exceptional customer service and support to our members throughout the claims process

Complex Claims Specialist

Waterloo, ON · On-site

CA$84K - CA$131K/yr

... insurance provider in the world? Look no further than Zurich Canada. If you have experience in ... Drive system and process improvements to enhance efficiency and customer service. Provide technical ...

Claims Concierge

Cambridge, ON · On-site

CA$48K - CA$73K/yr

During 2026, Gore will combine its operations with Unica Insurance, Beneva's Ontario-based ... During the recruitment process, we will discuss and consider how your unique qualifications align ...

New

Strong understanding of dental billing, insurance claims processing, and collections * Proven ability to train, support, and guide administrative team members * Positive, dependable, and able to ...

Strong understanding of dental billing, insurance claims processing, and collections * Proven ability to train, support, and guide administrative team members * Positive, dependable, and able to ...

AVP, Claims Analytics

Toronto, ON · On-site

CA$140K - CA$170K/yr

... recruitment process, including the initial review and screening of applications. Artificial ... Insurance or claims analytics experience. * Experience with Power BI, SQL, Python, Databricks, or ...

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Insurance Claims Processing information

Is claims processing a stressful job?

Insurance claims processing can be stressful due to tight deadlines, high workload, and the need for accuracy in evaluating claims. The role often requires strong attention to detail, communication skills, and the ability to handle difficult or emotional situations with claimants. However, workload and stress levels can vary depending on the employer and specific job environment.

What is insurance claims processing?

Insurance claims processing is the procedure by which insurance companies review, investigate, and settle claims made by policyholders. This process involves verifying the details of a claim, ensuring it meets the terms of the policy, and determining the appropriate payout or action. Claims processors handle documentation, communicate with claimants, and may work with other parties like adjusters or healthcare providers. The goal is to ensure claims are resolved efficiently, accurately, and fairly according to policy guidelines.

What are some common challenges faced in insurance claims processing, and how can new team members effectively manage them?

In insurance claims processing, new team members often encounter challenges such as handling high volumes of claims, interpreting complex policy language, and communicating effectively with policyholders and other stakeholders. To manage these challenges, it's important to develop strong organizational skills, stay detail-oriented, and proactively seek clarification when unsure about policy terms or procedures. Collaborating with experienced colleagues and taking advantage of ongoing training opportunities can also help new processors build confidence and efficiency in their daily tasks.

How to get a job as a claims adjuster with no experience?

To become a claims adjuster with no experience, focus on obtaining relevant certifications such as the Property and Casualty (P&C) license, which is often required. Gaining entry-level positions or internships in insurance companies can also help build industry knowledge and skills like communication and attention to detail, increasing your chances of starting a claims adjusting career.

What is the difference between Insurance Claims Processing vs Insurance Adjuster?

AspectInsurance Claims ProcessingInsurance Adjuster
CredentialsTypically requires a high school diploma or equivalent; certifications like CPCU or AIC are commonRequires a high school diploma; certifications like AIC or state licensing often needed
Work EnvironmentOffice-based, processing claims via computer systemsField and office work, inspecting damages and interviewing claimants
Employer & Industry UsageInsurance companies, third-party administratorsInsurance companies, independent adjusting firms
Primary FocusReviewing and processing insurance claims efficientlyAssessing damages and determining claim validity and payout

While both roles are essential in the insurance industry, Insurance Claims Processing focuses on handling and managing claims paperwork, whereas Insurance Adjusters evaluate damages and determine claim settlements. Understanding these differences helps job seekers identify the right career path within the insurance sector.

What are the key skills and qualifications needed to thrive in Insurance Claims Processing, and why are they important?

To excel in Insurance Claims Processing, you need strong attention to detail, analytical abilities, and a foundational understanding of insurance policies or claims procedures, often supported by a high school diploma or associate degree. Familiarity with claims management software, databases, and sometimes industry certifications like AIC (Associate in Claims) is common. Effective communication, problem-solving skills, and the ability to manage stressful situations make someone stand out in this role. These competencies are critical for ensuring claims are processed accurately, efficiently, and in compliance with regulatory standards.

What does an insurance claims processor do?

An insurance claims processor reviews and evaluates insurance claims to determine coverage and payout amounts. They verify policy details, gather necessary documentation, and ensure claims are processed accurately and efficiently, often using specialized software. Strong attention to detail and knowledge of insurance policies are essential for this role.
What are popular job titles related to Insurance Claims Processing jobs in Ontario? For Insurance Claims Processing jobs in Ontario, the most frequently searched job titles are:
What job categories do people searching Insurance Claims Processing jobs in Ontario look for? The top searched job categories for Insurance Claims Processing jobs in Ontario are:
Infographic showing various Insurance Claims Processing job openings in Ontario as of July 2026, with employment types broken down into 88% Full Time, 10% Part Time, and 2% Contract. Highlights an 86% Physical, 5% Hybrid, and 9% Remote job distribution.
Claims Fraud Analyst

CA$65K - CA$85K/yr

Other

Posted 3 days ago


Job description

The Opportunity

Are you looking for a caring, collaborative, values-driven workplace with inspiring teammates and leaders? Do you have the ambition and desire to be the best and thrive at one of the world's leading insurance providers? Look no further than Zurich Canada.

Zurich Canada is currently looking for a Claims Fraud Analyst to join the Data, Analytics & Artificial Intelligence team, supporting Claims and Fraud partners.

This role will help strengthen Zurich Canada's ability to identify potential claims fraud, leakage, unusual patterns, and emerging risk indicators through data, analytics, and business insight.

The successful candidate will work closely with Claims, Special Investigations Unit (SIU), Technology, and analytics teams to review claims data, develop fraud indicators, validate trends, and translate findings into clear recommendations that support better claims outcomes.

This is a unique opportunity to combine claims knowledge, analytical thinking, and investigative curiosity to help protect Zurich, our customers, and the integrity of the claims process. This posting is for an existing vacancy.

Zurich Canada uses artificial intelligence-enabled tools to support certain aspects of the recruitment process, including the initial review and screening of applications. Artificial intelligence is not the sole basis for candidate shortlisting or selection. All hiring decisions are reviewed and made by qualified hiring professionals.

Zurich follows a hybrid work model requiring in-person presence, which may include time in the office or market-facing engagements.

What you will do
  • Analyze claims data to identify potential fraud patterns, unusual activity, leakage, overpayments, and other risk indicators.
  • Partner with Claims and SIU teams to support investigation prioritization, case reviews, and indicator refinement.
  • Review historical fraud cases and pending claims to identify recurring themes, emerging trends, and opportunities to improve detection.
  • Develop dashboards, reports, and analysis that help business partners understand fraud trends, payment patterns, vendor activity, and claim behaviours.
  • Support the design, testing, and monitoring of fraud indicators, rules, models, and alerts in partnership with data and technology teams.
  • Conduct deep-dive analysis on claim payments, payees, vendors, body shops, service providers, recoveries, and claims expenses.
  • Validate data quality, definitions, and business rules to help ensure fraud insights are accurate, explainable, and actionable.
  • Prepare clear summaries, recommendations, and presentations for Claims, SIU, and leadership stakeholders.
  • Collaborate with cross-functional teams to improve data access, reporting consistency, and the responsible use of analytics in fraud detection.
  • Stay current on emerging fraud trends, analytical techniques, and opportunities to use data and AI-enabled capabilities responsibly.
Job Qualifications - What you bring to the table

Required:

  • Bachelors Degree and 3 or more years of experience in the Statistical Analysis area

OR

  • High School Diploma or Equivalent and 5 or more years of experience in the Statistical Analysis area

Preferred:

  • Bachelor's Degree and 2+ years of experience in claims, fraud, analytics, business intelligence, investigations, insurance operations, or a related field.
  • Strong analytical skills with the ability to interpret data, identify patterns, and connect insights to business actions.
  • Experience working with claims data, operational data, payment data, or other complex business datasets.
  • Strong communication skills with the ability to explain findings clearly to both technical and non-technical audiences.
  • Strong attention to detail, curiosity, sound judgment, and ability to handle confidential information appropriately
  • Insurance claims, fraud, special investigation, or claims analytics experience.
  • Experience with Power BI, SQL, Databricks, Python, or similar analytics tools.
  • Experience analyzing claims payments, vendor patterns, recoveries, leakage, expenses, or fraud indicators.
  • Understanding of claims processes, claim systems, policy information, and fraud investigation workflows.
  • Experience building dashboards, recurring reports, data quality checks, or analytical summaries.
  • Knowledge of predictive analytics, anomaly detection, machine learning, or AI-enabled fraud detection is an asset.
  • Ability to work independently, manage multiple priorities, and build trusted relationships across business and technical teams.

At Zurich Canada, we are committed to pay equity. We determine compensation based on objective criteria such as skills, experience, and internal equity. The salary range for this position is $65,000 - $85,000. This range reflects the expected pay for the role across Canada and may vary depending on factors like office location, specific responsibilities, and individual qualifications. As required by local law, Zurich provides in good faith a reasonable compensation range, but starting salaries may exceed this range based on a candidate's skills and experience. 

Our Culture
  • At Zurich, we are proud of our culture. We are passionate about Diversity, Inclusion, Equity and Belonging (DIEB). We want you to bring your whole self to work, and we want our employees to be reflective of the communities in which we live and work. Our DIEB initiatives are creating an environment where everyone feels welcome. 
  • We have a collaborative culture where diversity of thought is valued. We value your input and strive to give our employees the tools they need to make an impact. 
  • We care about our employees' well-being and offer a comprehensive health/benefits plan with varying levels of coverage to suit your specific needs and a competitive total compensation package. 
  • We understand how important it is to rest, recharge and do the things you love. At Zurich, all employees receive a minimum of four weeks of vacation per year to do just that. 
  • We also understand that employees require time off for personal reasons. Maybe you have an appointment during a workday, a cultural or religious holiday you would like to observe, or you need time off to focus on your mental health. Zurich employees receive four personal days per year to be used at their discretion.
  • We are committed to continuous improvement and offer access to a comprehensive range of training and development opportunities. 
  • We care about our communities. Our communities are where our customers, people, and shareholders live and work. While we can be proud of the contribution to society Zurich makes through our core business of insurance, we must also give back to our communities through our talent, time and resources. 
  • We have won numerous awards for our workplace culture. We are proud to be one of Greater Toronto's Top Employers and to have received Insurance Business Canada's 5-Star Diversity, Equity and Inclusion Award. 
     

Make a difference. Be challenged. Be inspired. Be supported. Love what you do. Work for us.

About Us

Zurich Canada is part of the Zurich Insurance Group, a multi-line insurer with approximately 55,000 employees worldwide serving customers in global and local markets. Zurich Canada has been a leading insurance provider serving mid-sized and large companies, including multinational corporations, in the Canadian commercial market for 100 years. With over 900 employees in offices across the country, Zurich offers the global strength of a top insurance provider combined with in-depth knowledge of industries and local markets. Zurich Canada aspires to be risk management professionals' first choice as their premier partner to help meet the risk challenges of today and tomorrow. Read more at www.zurichcanada.com.

A future with Zurich

Now is the time to move forward and make a difference. At Zurich, we want you to share your unique perspectives, experiences and ideas so we can grow and drive sustainable change together. As part of a leading global organization, Zurich North America has over 148 years of experience managing risk and supporting resilience. We are a leading provider of commercial property-casualty insurance solutions and a wide range of risk management products and services for businesses and individuals. Today, we serve more than 25 industries, from agriculture to technology and insure 90% of the Fortune 500. Our growth strategy is not limited to our business. As an employer, Zurich strives to provide ongoing career development opportunities and foster an environment where voices are diverse, behaviors are inclusive, actions drive equity, and our people feel a sense of belonging. Be a part of the next evolution of the insurance industry. Join us in building a brighter future for our people, our customers and the communities we serve.

As a global company, Zurich recognizes the diversity of our workforce as an asset. We recruit talented people from a variety of backgrounds with unique perspectives that are truly welcome here. Taken together, diversity and inclusion bring us closer to our common goal: exceeding our customers' expectations. Zurich is committed to providing a diverse, inclusive and barrier-free environment resulting in an accessible organization for employees, customers, and other parties who interact with, or on behalf of, Zurich. We strive to achieve a workplace free of discrimination of all forms, including discrimination on the basis of physical or mental disability, or medical condition. If you are interested in a job opportunity, please advise if you require an accommodation, so we can work with you to provide a more accessible process. 

Zurich does not accept unsolicited resumes from search firms or employment agencies. Any unsolicited resume will become the property of Zurich Canadian Holdings Limited. If you are a preferred vendor, please use our Recruiting Agency Portal for resume submission.

Only applicable for Canada: For Zurich Canada's commitment to diversity and accessibility please click here. If you would prefer to not receive future electronic messages from Zurich Insurance Company Ltd's recruitment management system, please email your request to have your job profile deleted from the system by clicking here. Zurich Insurance Company Ltd 100 King St., W., Suite 5500, Toronto, ON, M5X 1C9. www.zurichcanada.com