Senior Claims Operations Lead

Alight Solutions Ltd; Maine; Remote; USD 65,000 - 75,000; Full time

Job summary

Alight Solutions Ltd is seeking a Claims Operations Manager to oversee a claims team, drive service levels, and align client expectations with team performance. The role emphasizes strategic oversight, accountability, and continuous improvement within a flexible working environment.

Responsibilities include cross-team coordination for STD/FMLA programs, policy guidance, and maintaining high-quality customer service while ensuring compliance and data integrity.

Qualifications

• Leadership experience of 3+ years in STD/LTD product and claims management.
• Ability to manage day-to-day execution and projects to meet goals.
• Associate degree or equivalent professional work experience.
• Excellent communication and relationship-building abilities.
• Previous supervisory experience with prioritising and assigning work.
• Advanced level computer skills with Windows and MS Office (Word, Excel, PowerPoint, Outlook).
• Technical proficiency with data and business tools to drive efficiency and decisions.
• Strong analytical thinking and business acumen with creative agility.

Responsibilities

• Facilitate communication among Customer Care, Administrative and Clinical teams and partners for STD and FMLA absence programs.
• Ensure legal compliance and confidentiality with timely notifications to employees and clients.
• Review documentation to support claim approvals/denials and respond to audits.
• Act as Subject Matter Expert for Leave of Absence programs, guiding policies and processes.
• Lead a virtual team, define roles, and establish direct accountabilities to reach goals.
• Provide ongoing client support with diagnostic skills to identify root causes and suggest actions.
• Manage team performance against KPIs and service guarantees.
• Oversee day-to-day operations: workload, performance, development, and goals.
• Respond to inquiries promptly and participate in client meetings and implementations.
• Monitor staff schedule adherence and communicate changes to processes.

Skills

Leadership

Communication

Supervisory experience

Analytical thinking

MS Office

Education

Associate degree or equivalent professional work experience

Tools

Windows

Microsoft Office

Job description

Alight Solutions Ltd is seeking a Claims Operations Manager to oversee a claims team, drive service levels, and align client expectations with team performance. The role emphasizes strategic oversight, accountability, and continuous improvement within a flexible working environment.

Responsibilities include cross-team coordination for STD/FMLA programs, policy guidance, and maintaining high-quality customer service while ensuring compliance and data integrity.