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Medical Claims Processing Jobs in Alberta (NOW HIRING)

BFL Canada

Claims Advisor - Real Estate

Calgary, AB · Hybrid

... medical and dental coverage, telemedicine, employee and family assistance program, and retirement ... aspects of the selection process. Offers of employment at BFL CANADA are conditional upon ...

destinationone Consulting

Various locations across Alberta The Medical Billing Specialist is responsible for managing the billing process for a healthcare practice, ensuring accurate and timely submission of claims and ...

Cencora

Assistant, Specialty Pharmacy

Edmonton, AB · On-site

... care operations, claims processing, medication access, fulfillment support, or a related ... In addition to traditional offerings like medical, dental, and vision care, we also provide a ...

Cencora

Pharmacy Assistant

Edmonton, AB · On-site

... care operations, claims processing, medication access, fulfillment support, or a related ... In addition to traditional offerings like medical, dental, and vision care, we also provide a ...

Cencora

Pharmacy Assistant

Edmonton, AB · On-site

... care operations, claims processing, medication access, fulfillment support, or a related ... In addition to traditional offerings like medical, dental, and vision care, we also provide a ...

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All JobsMedical Claims Processing JobsMedical Claims Processing Jobs in Alberta

Medical Claims Processing information

What is medical claims processing?

Medical claims processing is the administrative procedure of reviewing, validating, and handling healthcare claims submitted by providers to insurance companies or payers for reimbursement. This process involves checking the accuracy of the submitted information, verifying patient eligibility and coverage, and ensuring that services are medically necessary and properly coded. Claims processors work to approve, deny, or request additional information to resolve claims, ultimately ensuring that healthcare providers receive payment and patients are billed accurately.

What are some common challenges faced in medical claims processing, and how can professionals address them?

Medical claims processors often encounter challenges such as handling complex insurance policies, navigating frequent regulatory changes, and ensuring the accuracy of coding and billing information. To address these issues, professionals need to stay updated with industry regulations, maintain strong attention to detail, and communicate effectively with healthcare providers and insurance companies. Ongoing training and the use of specialized software can also help streamline workflows and minimize errors, making the process more efficient.

What are the key skills and qualifications needed to thrive as a medical claims processor, and why are they important?

To thrive as a Medical Claims Processor, you need a solid understanding of medical terminology, insurance policies, and claims procedures, often supported by a high school diploma or associate degree. Familiarity with claims management software, healthcare coding systems (ICD-10, CPT), and electronic health record (EHR) systems is typically required. Attention to detail, strong organizational skills, and effective communication help ensure accuracy and timely processing. These skills are crucial for minimizing errors, reducing claim denials, and supporting efficient healthcare reimbursement processes.

What is the difference between Medical Claims Processing vs Medical Billing?

AspectMedical Claims ProcessingMedical Billing
CredentialsTypically requires knowledge of insurance policies and claims proceduresRequires understanding of coding and billing practices
Work EnvironmentOften in insurance companies, healthcare providers, or claims processing centersPrimarily in healthcare provider offices or billing companies
Employer & IndustryInsurance companies, healthcare providers, third-party administratorsHospitals, clinics, medical practices, billing services

Medical Claims Processing focuses on reviewing and submitting insurance claims for reimbursement, ensuring compliance with policies. Medical Billing involves coding patient services and generating bills for patients and insurers. While related, Claims Processing emphasizes claim review and approval, whereas Billing centers on creating accurate invoices for services rendered.

Do you need a degree to be a medical claims processor?

A degree is not typically required to become a medical claims processor, but employers often prefer candidates with a high school diploma or equivalent. Relevant skills include attention to detail, knowledge of medical billing and coding, and familiarity with claims processing software; certifications such as CPC or CPC-H can enhance job prospects.

How to get a job as a medical claims processor?

To become a medical claims processor, candidates typically need a high school diploma or equivalent, with some roles preferring postsecondary training or certification in medical billing and coding. Relevant skills include attention to detail, knowledge of insurance policies, and proficiency with claims processing software; certifications like Certified Professional Coder (CPC) can improve job prospects. Entry-level positions often require basic computer skills and understanding of healthcare terminology, with on-the-job training provided for specific systems used by employers.

What are popular job titles related to Medical Claims Processing jobs in Alberta?

For Medical Claims Processing jobs in Alberta, the most frequently searched job titles are:

Medical Claims Processing jobs near you
Infographic showing various Medical Claims Processing job openings in Alberta as of August 2026, with employment types broken down into 1% As Needed, 76% Full Time, 17% Part Time, and 6% Contract. Highlights an 89% Physical, 1% Hybrid, and 10% Remote job distribution.

Disability Claims Coordinator (Construction Industry)

Sureway Construction Group

Edmonton, AB • On-site

Full-time

Posted 13 days ago

Job description

Disability Claims Coordinator/Collection Technician (Construction Industry)

Sureway Construction Group of Companies is recruiting for a professional Disability Claims Coordinator/Collection Technician to join our team!

Sureway Construction Group offers a fantastic opportunity to join a leading team in the construction industry. We offer a friendly, fast-paced environment, great benefits, and a strong team of professionals.

Location: Edmonton, AB (9175 – 14 Street NW) Please note: there is no direct access to public transportation.

Hours:  Permanent, Full-time, Monday-Friday; 7:30am – 4:30pm (IN-OFFICE), On-Call (Evenings & Weekends)

Requirements:

  • Personal Reliable Vehicle

Pre-employment:

  • Drug and alcohol testing (swab-based test)
  • Successful completion of Company Orientation and site-specific orientation

 

Disability Claims Coordinator Responsibilities:

  • Management of the Disability Claims process including WCB, Short- Term and Long-Term Disability for Sureway Group of Companies, including the Modified Work Program.
  • Manage the Substance Abuse Program.
  • Demonstrate problem solving and critical thinking when determining the relationship between mechanism of injury and diagnosis by gathering and analyzing relevant information and planning to facilitate a return to work.
  • Interpreting medical reports and coordinating medical treatment.
  • Determining entitlement of medical and financial benefits.
  • Establishing compensation rates, determining the appropriate wage replacement benefits. payable and determining medical aid and non-rate based entitlements.
  • Building strong relationships with stakeholders and collaborating with them in the return to work process every step of the way.
  • Manage interjurisdictional claims.
  • Manage Cost Relief.
  • Other duties as required to support departmental requirements.

Disability Claims Coordinator Knowledge, Skills & Abilities:

  • Post-Secondary Education in Occupational Health and Safety, Disability Management, or a related degree.
  • Minimum 3 years of WCB experience and short-term and long-term disability management.
  • A solid understanding of the Alberta Workers’ Compensation system, its hierarchy, departments and workflow is required, as well as having sound business knowledge.
  • A good understanding of WorkSafeBC and Saskatchewan WCB, is considered an asset.
  • Experience in caseload management, vocational rehabilitation and/or bodily injury

insurance claims.

  • Familiarity with medical or rehabilitative terminology is an asset.
  • The ability to understand and apply policy while understanding the need for creative problem solving, critical thinking, independent decision-making and flexibility skills.
  • Effective communication skills – active listening, collaboration and effective verbal and written communication skills.
  • High degree of confidentiality.
  • Strong negotiation and conflict management skills.
  • Ability to creatively solve complex and sensitive issues.
  • Ability to multitask and be highly organized.
  • Proficiency in the use of the Internet, Microsoft Word/Excel, MS Outlook.
  • Demonstrate effective negotiation, mediation, and conflict resolution skills to resolve differing opinions on a wide variety of claim issues. This includes workers, employers, and medical and other service providers.

Specimen Collector Responsibilities:

  • Conduct drug collections and testing, as well as alcohol testing. 
  • Booking 3rd party pre-employment, post-incident & reasonable cause testing.
  • Organize and maintain paperwork flow and process.
  • Deliver test results to donors.
  • Follow up on lab collections.
  • Order supplies.
  • Organize calibration of equipment.

Sureway Construction Group is an equal opportunity employer. We would like to thank all applicants for submitting their resume; however only those selected for an interview will be contacted.

**No recruitment agencies please**

#SWSC4

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