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Insurance Claims Processing Jobs in Toronto, ON (NOW HIRING)

Zurich Insurance Group

Claims Data Analyst

Toronto, ON

CA$65K - CA$85K/yr

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

HUB

Senior Claims Specialist

Toronto, ON · On-site

CA$78K - CA$97K/yr

This is a great opportunity for an Insurance Broker, Claims Adjuster, or Insurance Professional ... Providing guidance to internal teams on the claims process and building knowledge and capability ...

Zurich Insurance Group

Complex Claims Specialist

Toronto, 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 ...

Zurich Insurance Group

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 required. * Experience with Power BI, SQL, Python ...

MHMI

Senior Dental Administrator

Toronto, ON

CA$24 - CA$28/hr

  • Dental

  • PTO

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 ...

MHMI

Senior Dental Administrator

Toronto, ON

$24 - $28/hr

  • Dental

  • PTO

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 ...

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All JobsInsurance Claims Processing JobsInsurance Claims Processing Jobs in Toronto, ON

Insurance Claims Processing information

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 the key skills and qualifications needed to thrive in insurance claims processing?

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 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.

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.

How to get a job as an insurance claims processor?

To become an insurance claims processor, candidates typically need a high school diploma or equivalent, with some roles preferring postsecondary training or certifications in insurance or claims processing. Relevant skills include attention to detail, communication, and familiarity with claims management software. Gaining experience through internships or entry-level positions can improve job prospects, and some employers may require background checks or specific licensing depending on the state or company policies.

Is insurance claims processing a stressful job?

Insurance claims processing can be a stressful job due to tight deadlines, high workload, and the need for accuracy in evaluating claims. It often requires strong attention to detail, communication skills, and the ability to handle difficult customer interactions, which can contribute to job-related stress.

What does an insurance claims processing 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 claims management software. 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 Toronto, ON?

For Insurance Claims Processing jobs in Toronto, ON, the most frequently searched job titles are:

What job categories do people searching Insurance Claims Processing jobs in Toronto, ON look for?

The top searched job categories for Insurance Claims Processing jobs in Toronto, ON are:

What cities near Toronto, ON are hiring for Insurance Claims Processing jobs?

Cities near Toronto, ON with the most Insurance Claims Processing job openings:

Insurance Claims Processing jobs near you
Infographic showing various Insurance Claims Processing job openings in Toronto, ON as of August 2026, with employment types broken down into 1% As Needed, 73% Full Time, 21% Part Time, and 5% Contract. Highlights an 89% Physical, 1% Hybrid, and 10% Remote job distribution.

Claims Processing Specialist ( Fixed Term)

WCG International Consultants Ltd.

Toronto, ON • Remote

Full-time

Posted 14 days ago

Job description

Company Description

We believe in the power of work. Since 1994, we’ve been partnering with governments and local agencies across Canada to create sustainable employment opportunities for people, businesses and communities. We understand that work gives hope, strengthens relationships and drives economic growth.

Job Description

About the role

Location: Remote - Canadian Home Office 

Status: Fixed Term until December 31st, 2026

As a Claims Processing Specialist, you’ll be responsible processing performance-based funding alongside employment- related financial supports for clients and employer expenditures. You will work closely with the Claims Manager and Financial Quality and Support Specialist to ensure accuracy, compliance and continuous quality improvement while maintaining high level of confidentiality pertaining to client records and financial information. 

What you'll do

  • Process client and employer financial support claims and ensuring contractual and legislative requirements are met
  • Ensure quality assurance for claims/invoices processed by Service Provider staff
  • Answer inquiries from staff regarding claims and other administrative questions
  • Communicate any issues regarding ineligible claims in line with processes
  • Provide support and guidance to staff regarding claims processing in line with contractual and guideline requirements
  • Keep abreast of emerging trends for claims assessment and flag these to the Claims Manager.
  • Demonstrate flexibility to be able to change activities based on changing requirements and business needs '
  • Ensure discrepancies are handled appropriately and escalating issues when necessary; refer staff to appropriate team members or internal partners as appropriate
  • Protect the interests of the organization – identify and manage risks, and escalate non-standard, high-risk transactions / activities as necessary
  • Develop a strong understanding of WCG’s contract, guidelines, policies, and process
  • Undertake standard and ad hoc data entry tasks
  • Effective use of WCG’s Case Management System and other systems and databases
Qualifications

What you bring

  • Strong auditing background and data entry experience
  • Minimum 2-3 years’ experience in a similar role working in a service-oriented organization
  • Proficient in MS Office especially Excel and Word
  • Detail oriented with a high level of accuracy
  • Ability to adapt to change
  • Understanding of the needs of a highly confidential environment
  • Able to maintain composure during difficult and high-pressure situations
  • Results driven with creative approach to idea generation and problem solving
  • Excellent organizational and time management skills
  • Ability to working in fast paced environment with changing workload

Preferred Criteria:

  • Bilingual (English and French)
  • Knowledge of the Employment Services industry

For complete job requirements, see the full Job Description here.


Additional Information

What we offer

  • Competitive salary of $53,040 per year
  • Ongoing learning and development opportunities
  • Generous time off policy to encourage work/life balance
  • A diverse and inclusive workplace with a track record of high employee engagement and teamwork

Diversity, Equity, Inclusion and Belonging Matter

WCG is strengthened by diversity. We are committed to achieving a workplace that is equitable and representative of Canada’s diverse population. We actively work to attract, develop, and retain employees from diverse and equity-deserving backgrounds who have exceptional ability and the desire to make a difference. We continuously strive to support individual needs and differences in a work environment that is built on inclusivity and respect for everyone.

WCG is committed to providing an accessible, barrier free recruitment and selection process. If contacted for an employment opportunity, please advise us if you require accommodation in advance of any part of the recruitment and selection process.

Passion and Lived Experience Matter!

If you don’t quite have the above credentials but feel passionate about this role and your ability to do it successfully, please APPLY ANYWAY! Tell us in your application why you believe you would be a great fit. We believe in developing talent and have a wide range of opportunities to support passionate team members as they grow towards their employment goals.