Remote Claims Operations Leader

Alight Solutions Ltd; Arkansas; Hybrid; USD 65,000 - 75,000; Full time

Job summary

Alight Solutions Ltd is seeking an experienced Claims Operations Manager to lead a diverse claims team and ensure service goals, SLAs, and client commitments are met. This role emphasizes strategic oversight and continuous improvement within a global benefits organization.

You will coordinate cross-functional collaboration across care, administrative, and clinical teams, manage KPIs, and drive talent development while supporting flexible working arrangements and occasional travel to client sites.

Qualifications

• Three or more years of leadership in STD/LTD product and claims management.
• Associate degree or equivalent professional work experience.
• Strong communication and relationship-building abilities.
• Prior supervisory experience and ability to prioritize and assign work.
• Proficiency with Windows and Microsoft Office suite.

Responsibilities

• Facilitating communication among the Customer Care, Administrative, and Clinical teams including employees, client companies, healthcare providers and clinical partners for STD and FMLA absence programs.
• Ensuring legal compliance and confidentiality by providing timely notifications to employees and client organizations.
• Reviewing documentation to support claim approvals and denials and responding to audit requests per regulatory and company requirements.
• Acting as a Subject Matter Expert for Alight's Leave of Absence programs, guiding policies and client requirements; ensuring compliant service delivery and resolving complex cases.
• Leading a virtual team, defining roles and responsibilities and establishing direct accountabilities to achieve business goals.
• Providing ongoing client support with diagnostic skills to identify root causes and proposing solutions to prevent recurrence.
• Managing team performance against KPIs and ensuring service and performance guarantees are met.
• Overseeing day-to-day operations, workload distribution, performance management, and staff development.
• Responding timely to client and internal inquiries with proper communication style and tone.
• Monitoring staff schedule adherence and communicating updates to processes and procedures.

Skills

Leadership experience

Communication skills

Supervisory experience

Analytical thinking

Project management

Education

Associate degree or equivalent professional work experience

Tools

Windows OS

Microsoft Office

Job description

Alight Solutions Ltd is seeking an experienced Claims Operations Manager to lead a diverse claims team and ensure service goals, SLAs, and client commitments are met. This role emphasizes strategic oversight and continuous improvement within a global benefits organization.

You will coordinate cross-functional collaboration across care, administrative, and clinical teams, manage KPIs, and drive talent development while supporting flexible working arrangements and occasional travel to client sites.