MB-2912 - USA (New Jersey) - Third Party Workers Compensation Claims Administration, Loss Control Services and Managed Care Services - Deadline April 15,2019

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-2912

Government Authority located in New Jersey; USA based organization looking for expert vendor for third party workers compensation claims administration, loss control services and managed care services.

[A] Budget: Looking for Proposals

[B] Scope of Service:

(1) Vendor needs to provide third party workers compensation claims administration, loss control services and managed care services.
- Supervise the county’s obligation to employees who sustain bodily injury or neurological injury and occupational illnesses in the county service or employ, including those employees in the service or employ of the county board of social services.
- Investigate, handle, and adjust to conclusion all claims with a date of loss occurring during the term of the contract.
- Compile and file all notices and reports required under workers compensation law, including electronic data interchange reporting of first report of injury and subsequent reports of injury claims data to the compensation rating and inspection bureau.
- Maintain accurate records of all details incident to all workers compensation claims filed against the county.
- Provide for the claim supervision and administration necessary for the disposition of workers compensation claims filed by employees against the county, including field investigation and subrogation activity.
- Provide attendance and representation when necessary on behalf of the county at workers compensation hearings.
- Engage experienced workers compensation attorneys (subject to the approval of the county) to represent the county at all formal hearings and at all appeals therefrom; however, the fees for such legal services will be paid out of the fund held by the county for payment of benefits and expenses.
- Review all legal, medical, and expense invoices for accuracy and reasonableness of charges.
- Prepare and mail with the laser printed signatures of the county treasurer and clerk of the board, all checks to satisfy all claims, medical, legal and other expenses incurred in processing claims against the county.
- The county shall make deposits directly to a claim fund account in such amounts as is necessary to cover checks drawn in payment of claim benefits and costs related thereto. Envelopes with the offer’s return address and proper postage shall accompany the above checks. The check register shall be formatted to allow the county and bank to process through a positive pay security procedure.
- Prepare and submit a monthly listing all checks issued during the month. The listing shall contain the following information; check number, transaction date, amount, payee, and name of employee and claim number.
- Prepare and submit to the county a monthly report of each claim identifying: date, cause, location, name of claimant, claim number, status, amounts paid, reserved and incurred subrogation recovery anticipated and collected. At the request of the county, prepare reports in preparation of annual audits pertaining to indemnity amounts, reserves, medical, legal and reserve expenses.
- Conduct adequate and appropriate orientation meetings with county personnel.
(2) All questions must be submitted no later than March 22, 2019.    
(3) Contract term will be one year.

[C] Eligibility:

- Onshore (USA Only);

[D] Work Performance:

Performance of the work will be Offsite. Vendor needs to carry work in their office location.

Expiry Date : Monday, 15 April, 2019

Question Answer Deadline : Friday, 22 March, 2019

Category : Medical Billing and Coding

Country : USA

State : New Jersey

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