Workers Compensation Claim Consultant

Job Description

Job Description

Overview

OneGroup 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.

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

OneGroup’s company culture sets us apart from the rest. Our core values, what we call “The OneGroup 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.

Responsibilities

The Workers Compensation Claims Consultant serves as a strategic advisor to clients, delivering proactive, data-driven claims management solutions that reduce total cost of risk and improve claim outcomes. This role collaborates with clients, carriers, and internal teams to anticipate trends, identify cost drivers, and implement forward-looking claim strategies for workers compensation claims.

The consultant partners closely with clients to translate claims data into actionable insights, provides ongoing guidance on risk mitigation and claim resolution strategies, and ensures alignment between claims handling practices and each client’s broader risk management objectives.

Essential Duties & 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

Qualifications

Education:

• Associate Degree or other equal experience preferred

Professional Certifications/Licenses:

• AIC Designation or equivalent insurance designation
• Property/Casualty License preferred

Experience/Skills:

• 5+ years’ of workers’ compensation.
  • 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