Claims Consultant

Community Financial System, Inc.•Syracuse, NY

About The Position

The Claims Consultant is a client-facing technical advisor responsible for complex commercial Property & Casualty claims, excluding Workers’ Compensation. The role provides claim strategy, coverage consultation, client advocacy, carrier accountability, and executive-level guidance while partnering with clients, carriers, legal counsel, Producers, Account Executives, Risk Management Consultants, and other stakeholders. Primary lines of coverage include Commercial Property, General Liability, Commercial Auto, Inland Marine, Builders Risk, Professional Liability, Employment Practices Liability, Management Liability, Cyber, Crime and Fidelity, Umbrella and Excess, and other specialty P&C coverages. OneGroup is an independent insurance and risk management organization with more than 200 professionals across 18 locations. It is headquartered in Syracuse, New York, and is a subsidiary of Community Bank, NA. The company describes its culture through its “OneGroup Way” values: Knowledge Development, Big Picture, Acknowledgement, Transparency, and Bigger Purpose.

Requirements

Five or more years of progressively responsible commercial P&C claims experience with a brokerage, carrier, TPA, independent adjusting firm, or comparable organization.
Demonstrated experience with complex commercial claims, coverage issues, reserves, litigation, settlement considerations, and carrier escalation.
Strong knowledge of commercial Property, General Liability, Auto Liability, and related P&C coverage forms and claim processes.
Strong judgment, analytical ability, negotiation, writing, presentation, and relationship-management skills.
Ability to communicate confidently with clients, carriers, adjusters, legal counsel, Producers, and leaders.
Proficiency with Microsoft 365.
Ability to meet the physical demands of the job, including standing, walking or sitting; using hands and fingers; reaching; speaking and hearing; occasionally lifting or moving up to 25 pounds; and close vision and focusing.

Nice To Haves

Experience with Applied Epic or another agency or claims-management system.
Associate or bachelor’s degree in insurance, risk management, business, finance, or a related discipline.
AIC, ARM, CPCU, or comparable insurance designation.
Property & Casualty producer and/or claims-adjuster licensing, based on role and jurisdiction.
Experience supporting large or multi-location commercial clients and facilitating claim reviews, stewardship meetings, analytics, and executive presentations.

Responsibilities

Lead high-severity, complex, litigated, sensitive, or coverage-challenged claims and develop action plans, ownership, and resolution objectives.
Review liability, financial exposure, reserves, settlement posture, litigation developments, and carrier handling.
Analyze policy language, endorsements, exclusions, reservations of rights, coverage positions, and denials; advocate for appropriate carrier review and escalation.
Coordinate with carriers, TPAs, counsel, experts, vendors, and internal leadership while maintaining boundaries between consultation, carrier authority, and legal advice.
Identify subrogation, risk-transfer, tender, indemnification, and recovery opportunities when applicable.
Serve as claims advisor for assigned clients and lead large-loss reviews, stewardship and service-plan discussions, and executive claim presentations.
Provide proactive updates explaining significant developments, business implications, client actions, and next steps.
Evaluate carrier and TPA performance, address delays or service concerns, and escalate unresolved issues to appropriate leadership.
Contribute claims insight to renewal, placement, retention, and carrier-selection discussions.
Review loss runs, reserves, claim duration, severity, closure activity, and recurring loss drivers, and translate findings into practical recommendations.
Partner with Risk Management Consultants to connect claim trends with loss-prevention and risk-mitigation opportunities.
Partner with Producers, account service teams, and other stakeholders to support client needs, new business, retention, and effective handoffs.
Contribute to service standards, escalation procedures, training, and continuous process improvement.
Maintain accurate and timely claim documentation, diary dates, communications, advice, and next steps in Applied Epic and other approved systems.
Protect confidential information and follow privacy, cybersecurity, documentation, escalation, and E&O-risk-management requirements.
Immediately escalate suspected reporting errors, missed deadlines, incorrect advice, or other potential E&O issues.