Remote Claims Operations Leader

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

Benefits offered by this job

Wellbeing programs

Retirement matching

Generous time off

Parental leave

Continuing education

Job summary

Alight Solutions Ltd in Wisconsin is seeking a Claims Operations Manager to oversee a claims team, ensuring service goals, metrics, and client commitments are met. The role emphasizes strategic oversight, accountability, and continuous improvement.

The candidate will align objectives with client needs, manage a virtual team, and drive productivity, SLA, and quality. Background checks and travel to offices may be required; competitive benefits apply.

Qualifications

• Leadership experience in STD/LTD product and claims management.
• Ability to manage day-to-day execution and projects to achieve business goals.
• Associate degree or equivalent professional work experience.
• Excellent communication and relationship-building abilities.
• Previous supervisory experience and ability to prioritize and assign work.
• Advanced level computer skills with Windows and MS Office (Word, Excel, PowerPoint, Outlook).
• Ability to leverage technology, data and business tools to improve customer experience.
• Strong analytical business acumen and strategic thinking.
• Creative agility to address complex business and technical challenges.

Responsibilities

• Facilitating communication among Customer Care, Administrative, and Clinical teams and with employees, client companies, providers and partners for STD and FMLA absence programs.
• Ensuring legal compliance and confidentiality through timely notifications.
• Reviewing documentation to support claim approvals/denials and responding to audits.
• Serving as Subject Matter Expert for Leave of Absence programs and guiding policies and processes.
• Leading a virtual team, defining roles, and building talent to achieve goals.
• Providing ongoing client support; diagnosing issues and recommending solutions to prevent recurrence.
• Managing team performance against KPIs and ensuring service guarantees are met.
• Overseeing day-to-day operations including workload distribution and staff development.
• Responding to client/internal inquiries; participating in client meetings and implementations.
• Monitoring staff schedule adherence and communicating process changes.

Skills

Leadership

Claims management

Communication

Supervisory experience

Education

Associate degree or equivalent

Tools

Windows

Microsoft Office

Word

Excel

PowerPoint

Outlook

Job description

Alight Solutions Ltd in Wisconsin is seeking a Claims Operations Manager to oversee a claims team, ensuring service goals, metrics, and client commitments are met. The role emphasizes strategic oversight, accountability, and continuous improvement.

The candidate will align objectives with client needs, manage a virtual team, and drive productivity, SLA, and quality. Background checks and travel to offices may be required; competitive benefits apply.