Remote Claims Operations Leader

Alight Solutions Ltd; Florida; On-site; USD 65,000 - 75,000; Full time

Job summary

Alight Solutions Ltd in Florida seeks a Claims Operations Manager to oversee a claims team, ensuring service goals and client commitments are met. The role emphasizes strategic oversight, accountability, and continuous improvement to align objectives with client and team performance.

You will lead a virtual team, manage KPIs, and drive productivity, quality, and customer satisfaction while maintaining compliance and fostering a high-performance culture. Travel to office locations may be required.

Qualifications

• Have leadership experience of three or more years in STD/LTD product and claims management knowledge.
• Demonstrate the proven ability to manage both day-to-day execution and projects to achieve results of business goals and special assignments.
• Possess an associate degree or equivalent professional work experience.
• Display excellent communication and relationship-building abilities.
• Have previous supervisory experience and the ability to prioritize and assign work.
• Have advanced level computer skills using Windows and Microsoft Office suite of programs including Word, Excel, PowerPoint and Outlook.
• Show technical proficiency by utilizing technology, data, and business tools to foster innovation, boost efficiency, support decision-making, and enhance customer experience.
• Display expert critical thinking skills with proven analytical business acumen.
• Have creative agility to address complex business and technical challenges.

Responsibilities

• Facilitating communication among the Customer Care, Administrative, and Clinical teams.
• 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 in accordance with regulatory and company requirements.
• Acting as a Subject Matter Expert for Alight's Leave of Absence programs, offering guidance on policies, processes, and client requirements.
• 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 cause of client issues and developing solutions.
• Managing team performance against established KPIs and ensuring all service and performance guarantees are achieved.
• Overseeing day-to-day operations, including workload distribution, performance management, and employee development.
• Responding timely to client and internal inquiries and participating in client meetings and implementations.
• Monitoring and maintaining staff schedule adherence and communicating new processes and changes.

Skills

Leadership experience

Supervisory experience

Communication skills

Prioritization

Analytical thinking

Technical proficiency

Creative agility

Problem solving

Education

Associate degree

Tools

Microsoft Office

Job description

Alight Solutions Ltd in Florida seeks a Claims Operations Manager to oversee a claims team, ensuring service goals and client commitments are met. The role emphasizes strategic oversight, accountability, and continuous improvement to align objectives with client and team performance.

You will lead a virtual team, manage KPIs, and drive productivity, quality, and customer satisfaction while maintaining compliance and fostering a high-performance culture. Travel to office locations may be required.