Senior Claims Operations Leader

Alight Solutions Ltd; Oregon; Hybrid; USD 65.000 - 75.000; Vollzeit

Zusammenfassung

Alight Solutions Ltd in the United States seeks a Claims Operations Manager to lead a claims team, meet service goals and client commitments, and drive continuous improvement with strategic oversight.

Responsibilities include cross‑functional coordination, compliance and confidentiality, documentation review for approvals/denials, and developing talent to sustain quality service. Travel to client sites may be required. This role offers a comprehensive benefits package and career growth.

Qualifikationen

• Leadership of 3+ years in STD/LTD product and claims management.
• Proven ability to manage day-to-day execution and projects to achieve results.
• 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 using Windows and Microsoft Office.
• Technical proficiency with data, technology, and business tools to foster innovation and enhance customer experience.
• Strong analytical thinking and business acumen; critical thinking skills.
• Creative agility to address complex business and technical challenges.

Aufgaben

• Facilitating communication among the Customer Care, Administrative, and Clinical teams.
• 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 in accordance with regulatory and company requirements.
• Acting as a Subject Matter Expert for Alight's Leave of Absence programs, offering guidance on policies, processes, and client requirements.
• Leading a virtual team, defining roles and responsibilities and establishing direct accountabilities to achieve business goals.
• Providing ongoing client support with diagnostic skills to identify root cause of client issues.
• Managing team performance against established KPIs and ensuring all service and performance guarantees are consistently achieved.
• Overseeing day-to-day operations, including workload distribution, performance management, employee development, and goal setting to drive business results.
• Responding timely and accurately to client and internal inquiries, according to established standards with attention to style, tone, and manner of communication.
• Monitoring and maintaining staff schedule adherence while ensuring timely communication of new and updated processes, procedures, and operational changes.

Kenntnisse

Leadership

Communication

Supervisory skills

Analytical thinking

Creative agility

Ausbildung

Associate degree

Tools

Windows

Microsoft Office

Jobbeschreibung

Alight Solutions Ltd in the United States seeks a Claims Operations Manager to lead a claims team, meet service goals and client commitments, and drive continuous improvement with strategic oversight.

Responsibilities include cross‑functional coordination, compliance and confidentiality, documentation review for approvals/denials, and developing talent to sustain quality service. Travel to client sites may be required. This role offers a comprehensive benefits package and career growth.