Senior Claims Strategist - Commercial P&C (Client-Facing)

Community Bank, N.A.; New York (NY); On-site; USD 66,000 - 109,000; Full time

Benefits offered by this job

11 paid holidays

Paid vacation

Medical insurance

Vision & Dental insurance

401K with match

Pension

Tuition Reimbursement

Banking discounts

Job summary

OneGroup, a leading North East insurance and risk management firm, is seeking a Claims Consultant to serve as a client-facing technical advisor for complex commercial P&C claims, excluding Workers' Comp.

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.

Qualifications

• 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.
• Experience with Applied Epic or another agency or claims-management system preferred; proficiency with Microsoft 365 required.

Responsibilities

• Lead high-severity, complex, litigated, sensitive, or coverage-challenged claims and develop clear 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 clear boundaries between consultation, carrier authority, and legal advice.
• Identify subrogation, risk-transfer, tender, indemnification, and recovery opportunities when applicable.
• Serve as the claims advisor for assigned clients and lead large-loss reviews, stewardship and service plan discussions, and executive claim presentations.
• Provide proactive, practical updates that explain significant developments, business implications, client actions, and next steps.
• Evaluate carrier and TPA performance, address delays or service concerns, and elevate 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; 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 elevate suspected reporting errors, missed deadlines, incorrect advice, or other potential E&O issues.

Skills

Strategic claims judgment

Client advocacy

Coverage analysis

Negotiation and influence

Carrier accountability

Executive communication

Analytical thinking

Technical leadership

Documentation discipline

Cross-functional collaboration

Education

Bachelor's degree in insurance/risk management/business

Tools

Applied Epic

Microsoft 365

Job description

OneGroup, a leading North East insurance and risk management firm, is seeking a Claims Consultant to serve as a client-facing technical advisor for complex commercial P&C claims, excluding Workers' Comp.

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.