Remote Claims Operations Manager - Lead & Optimize

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

Job summary

Alight seeks a Claims Operations Manager to oversee a claims team, ensure service goals, and meet client commitments with strong strategic oversight and accountability. The role emphasizes engagement and continuous improvement to achieve productivity, SLA, quality, and customer satisfaction targets.

The position leads a virtual team, drives KPI performance, and guides complex cases while ensuring compliance with regulatory requirements and company standards.

Qualifications

• Ability to lead a claims team and drive performance
• Experience managing STD/LTD product and claims operations
• Strong communication and relationship-building abilities

Responsibilities

• Facilitating cross-team communication among Customer Care, Administrative, and Clinical teams
• Ensuring legal compliance and confidentiality in notifications to employees and clients
• Reviewing documentation to support claim approvals/denials and audit responses
• Acting as SME for Leave of Absence programs and guiding processes
• Leading a virtual team with clear roles and accountability to meet KPIs
• Providing analysis to identify root causes and propose corrective actions
• Managing day-to-day operations, workload, performance, and staff development
• Responding to client and internal inquiries with professional communication and timing
• Monitoring staff schedule adherence and rolling out updated processes

Skills

Leadership

Claims management

Communication

Supervisory experience

Project management

MS Office

Windows

Education

Associate degree or equivalent professional work experience

Tools

Microsoft Office

Windows

Job description

Alight seeks a Claims Operations Manager to oversee a claims team, ensure service goals, and meet client commitments with strong strategic oversight and accountability. The role emphasizes engagement and continuous improvement to achieve productivity, SLA, quality, and customer satisfaction targets.

The position leads a virtual team, drives KPI performance, and guides complex cases while ensuring compliance with regulatory requirements and company standards.