Claims Consultant

Overview

One Group is a team of more than 200 insurance and risk management professionals who are ONE company acting as ONE team, with ONE focus and ONE mission:
To serve each client as our ONE client.

One Group is one of the fastest growing independent insurance and risk management organizations in the northeast. With team members in 18 locations, One Group can provide best in class client resources while maintaining an entrepreneurial, friendly and fun environment. A subsidiary of Community Bank, NA (NYSE: CBU), One Group is headquartered in Syracuse, NY.

One Group’s company culture sets us apart from the rest. Our core values, what we call “The One Group Way” consists of the following:

• Knowledge Development – Professional growth but also understanding the company, workflow processes, and the right people to get the job done. Adopting a growth mindset in everything we do.
• Big Picture – How your individual contributions connect to the bigger things around us that can make a difference to the client. How do you utilize your talents and the attributes of those around you to create a unique solution for the client.
• Acknowledgement – Recognize others contributions, appreciate what others do and their strengths.
• Transparency – An environment that encourages open communication and feedback.
• Bigger Purpose – How do we become more than just an insurance company to our clients? We seek to enhance our client’s businesses, support their mission, and understand their challenges.

The Claims Consultant is responsible for the professional management of non complex Auto Liability and General Liability claims, exercising independent judgment in claim handling, client advisement, and coordination with carriers and internal stakeholders. This role serves as a trusted claims resource for clients and producers, ensuring claims are managed efficiently, accurately, and in accordance with policy terms, carrier best practices, and organizational standards.

Essential Duties and Responsibilities:

• Independently manage a portfolio of non complex Auto Liability and General Liability claims from intake through resolution, applying professional judgment to determine appropriate actions within established guidelines.
• Evaluate claim submissions to confirm coverage applicability, policy terms, and documentation requirements; identify and resolve discrepancies as needed.
• Report claims to carriers, communicate material information to clients and producers, and oversee timely carrier engagement, including adjuster assignment and acknowledgements.
• Serve as the primary claims contact for clients, carriers, TPAs, and internal teams, providing guidance, interpretation, and status updates throughout the claim lifecycle.
• Monitor claim activity, including reserves and carrier handling practices, to ensure alignment with industry standards and carrier best practices; elevate concerns or higher exposure matters as appropriate.
• Exercise discretion in prioritizing workload, addressing issues, and determining when matters require senior level involvement.
• Maintain accurate, complete, and compliant claim documentation within EPIC and related systems.
• Collaborate with producers, account teams, and senior claims staff to support client service objectives and claims outcomes.
• Provide support and guidance to Senior Claims Consultants as requested and contribute to continuous improvement of claims processes.
• Perform additional professional duties as assigned.
• Maintain proficient knowledge of, and demonstrate ongoing compliance with all laws and regulations applicable to this position, ensure ongoing adherence to policies, procedures, and internal controls, and meet all training requirements in a timely manner.

Core Competencies:

• Client focused professional service orientation
• Independent judgment and decision making
• Strong attention to detail and analytical thinking
• Clear, confident, and professional communication
• Problem solving within established guidelines
  
  Ability to work independently and collaboratively

• Minimum of 3–5 years of claims experience with an insurance broker, carrier, or third party administrator.
• Demonstrated knowledge of…