Workers Compensation Claim Consultant

Community Financial System, Inc.•Syracuse, NY

3d•Hybrid

About The Position

OneGroup is a rapidly growing independent insurance and risk management organization with a strong focus on client service and a collaborative company culture. As a subsidiary of Community Bank, NA, OneGroup operates with a mission to serve each client as their sole focus. The company values knowledge development, a big-picture perspective, acknowledgement of contributions, transparency, and a purpose that extends beyond insurance to enhancing client businesses. The Workers Compensation Claims Consultant will act as a strategic advisor, providing data-driven claims management solutions to reduce the total cost of risk and improve claim outcomes. This role involves close collaboration with clients, carriers, and internal teams to anticipate trends, identify cost drivers, and implement forward-thinking strategies for workers' compensation claims. The consultant will translate claims data into actionable insights, offer guidance on risk mitigation and claim resolution, and ensure alignment with client risk management objectives.

Requirements

Associate Degree or other equal experience preferred
AIC Designation or equivalent insurance designation
Property/Casualty License preferred
5+ years’ of workers’ compensation experience.
Multi line claims handling experience (commercial property, general liability, auto, professional liability) preferred.
Exceptional risk management and claims management skills related to Workers Compensation
NYS & NCCI Experience Rating experience
Excellent interpersonal communication and relationship building skills to include strong negotiation skills
Working knowledge of Agency Management Systems
Experience in the Applied Epic system is a plus, but not required.
Solid statistical analysis skills
Ability to work independently
Excellent writing skills
Proficiency in Microsoft Word, Excel and PowerPoint

Nice To Haves

Multi line claims handling experience (commercial property, general liability, auto, professional liability)
Experience in the Applied Epic system

Responsibilities

Serve as a trusted claims advisor, partnering with clients to develop and execute proactive claims management strategies aligned to their risk profile and business objectives.
Analyze claims trends, loss data, and reserve development to identify emerging risks and recommend cost-containment strategies before further escalation occurs.
Lead consultative claim reviews with clients, providing insight-driven recommendations, benchmarking data, and strategic action plans.
Collaborate with carriers and TPAs to influence claim outcomes, including reserving strategy, settlement approach, and closure timelines.
Proactively monitor key performance indicators (KPIs) such as reserve movement, closure rates, and experience modification factors, and advise clients on performance improvement opportunities.
Evaluate claim handling processes and recommend enhancements to improve efficiency, and optimize claim lifecycle outcomes.
Provide ongoing client education on claim best practices, regulatory considerations, and risk mitigation strategies, positioning OneGroup as a consultative partner rather than a transactional service provider.
Support sales and retention efforts by articulating the value of proactive claims management and demonstrating measurable client impact.
Facilitate development and implementation of targeted service plans that integrate claims strategy into overall risk management and client experience frameworks.
Serve as a central point of coordination while driving accountability among stakeholders (clients, carriers, vendors) to ensure execution of agreed-upon strategies.
Communicate with internal customers concerning client concerns and performance.