Remote Claims Operations Leader

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

Benefits offered by this job

Health, dental and vision coverage

Retirement plan with matching

Generous time off

Parental leave

Continuing education

Flexible working arrangements

Job summary

Alight Solutions Ltd. seeks a Claims Operations Manager to oversee a claims team, drive service levels, and align with client expectations. This role emphasizes strategic oversight, accountability, and continuous improvement across absence programs.

You will coordinate cross-functional efforts, monitor KPIs, and guide a virtual team to deliver compliant, high-quality service while building talent and ensuring customer satisfaction.

Qualifications

• Must have 3+ years of leadership in STD/LTD product and claims management.
• Proven ability to manage day-to-day work and projects to meet goals.
• Associate degree or equivalent professional experience required.
• Excellent communication and relationship-building abilities.
• Previous supervisory experience and ability to prioritise and assign work.
• Proficient in Windows and MS Office (Word, Excel, PowerPoint, Outlook).
• Demonstrated analytical mindset with business-focused thinking.
• Creative agility to address complex business and technical challenges.

Responsibilities

• Facilitate communication among Customer Care, Administrative, and Clinical teams and external clients.
• Ensure legal compliance and confidentiality in line with policies.
• Review documentation to support claim approvals/denials and respond to audits.
• Act as Subject Matter Expert for Leave of Absence programs and guidance on policies.
• Lead a virtual team, define roles, and establish accountability to meet goals.
• Provide client support using diagnostic skills to identify root causes and solutions.
• Manage team performance against KPIs and guarantees of service delivery.
• Oversee day-to-day operations including workload, performance management, and development.
• Respond timely to client/internal inquiries; participate in meetings and implementations.
• Monitor staff schedule adherence and communicate process changes.

Skills

Leadership experience

Supervisory experience

Strong communication

Analytical thinking

Problem solving

MS Office proficiency

Education

Associate degree or equivalent professional work experience

Tools

MS Office

Job description

Alight Solutions Ltd. seeks a Claims Operations Manager to oversee a claims team, drive service levels, and align with client expectations. This role emphasizes strategic oversight, accountability, and continuous improvement across absence programs.

You will coordinate cross-functional efforts, monitor KPIs, and guide a virtual team to deliver compliant, high-quality service while building talent and ensuring customer satisfaction.