Remote Claims Operations Manager

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

Benefits offered by this job

Flexible working arrangements

Benefits package

Job summary

Alight Solutions Ltd. is seeking a Claims Operations Manager to lead a claims team and ensure service goals, performance metrics, and client commitments are met.

The role emphasizes strategic oversight, accountability, and continuous improvement within a flexible working environment. The successful candidate will align corporate objectives with client expectations, drive productivity, and manage quality and customer satisfaction targets, while coordinating across care, administrative, and

Qualifications

• Leadership experience of three or more years in STD/LTD product and claims management knowledge.
• Ability to manage both day-to-day execution and projects to achieve 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 organizations and partners.
• 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.
• Acting as a Subject Matter Expert for Alight's Leave of Absence programs and ensuring compliant service delivery.
• Leading a virtual team, defining roles and responsibilities and establishing direct accountabilities.
• Providing ongoing client support with diagnostic skills to identify root causes of issues and developing solutions.
• Managing team performance against KPIs and ensuring service guarantees are met.
• Overseeing day-to-day operations, workload distribution, and employee development to drive results.
• Responding to client and internal inquiries with timely, accurate communication and participating in client meetings.
• Monitoring and maintaining staff schedule adherence while ensuring timely communication of new processes.

Skills

Leadership experience

Claims management

Education

Associate degree or equivalent

Tools

Windows

Microsoft Office

Job description

Alight Solutions Ltd. is seeking a Claims Operations Manager to lead a claims team and ensure service goals, performance metrics, and client commitments are met.

The role emphasizes strategic oversight, accountability, and continuous improvement within a flexible working environment. The successful candidate will align corporate objectives with client expectations, drive productivity, and manage quality and customer satisfaction targets, while coordinating across care, administrative, and