Remote Claims Operations Manager

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

Job summary

Alight Solutions Ltd in the United States seeks a Claims Operations Manager to oversee a claims team, achieve service goals, and align client expectations with performance. The role emphasizes strategic oversight, accountability, and continuous improvement of SLA, quality, and customer satisfaction.

You will lead a virtual team, coordinate across Customer Care, Administrative, and Clinical groups, ensure compliance, review documentation for approvals/denials, and drive process enhancements to

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, including client companies and providers 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 on policies and client requirements, ensuring accurate service delivery.
• Leading a virtual team, defining roles and direct accountabilities to achieve business goals and building talent and culture.
• Providing ongoing client support with diagnostic skills to identify root causes and developing solutions to prevent recurrence.
• Managing team performance against KPIs and ensuring service and performance guarantees are met.
• 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 staff schedule adherence and communicating new processes and changes.

Skills

Leadership

Communication

Supervisory experience

MS Office

Windows

Education

Associate degree

Tools

Windows

Microsoft Office

Job description

Alight Solutions Ltd in the United States seeks a Claims Operations Manager to oversee a claims team, achieve service goals, and align client expectations with performance. The role emphasizes strategic oversight, accountability, and continuous improvement of SLA, quality, and customer satisfaction.

You will lead a virtual team, coordinate across Customer Care, Administrative, and Clinical groups, ensure compliance, review documentation for approvals/denials, and drive process enhancements to