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MB-3457 - USA (New York) - Worker Compensation Claims Administration Services - Deadline October 15,2019

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-3457

Government Authority located in New York; USA based organization looking for expert vendor for worker compensation claims administration services.

[A] Budget: Looking for Proposal

[B] Scope of Service:

(1) Vendor needs to provide worker compensation claims administration services,
- Provide claims administration services for workers’ compensation cases,
- Maintain files and records for all claim files including adjuster claim notes,
- Maintain records necessary for the defenses of the claims at workers’ compensation board hearings,
- Filing with the Worker's Compensation Board of all Section 15-8, 25-A, and Section 5105 cases, appeals with worker's compensation board and the courts, coordination and management of concurrent employment claims, negotiation of lump sum settlements; represent and provide pertinent case file information regarding third-party actions and any other related worker's compensation matters and issues, including non-employee claims,
- Provide necessary notification to all excess carriers on claims which threaten the Self-Insured retention levels, as required.
- Provide claim loss and management reports on a regular basis,
- Examine and review all claims that are submitted and create a file for each.  Determine the compensability of the claim and advise of such.
- Set the appropriate reserves for each case.
- Conduct appropriate investigations on all claims to determine their validity,
- Have appropriate medical staff available to review treatment in each case,
- Prepare and file all required forms,
- Arrange for representation at all Workers’ Compensation Board hearings,
- Prepare the litigation files for the defenses of the claim at Workers’ Compensation Board hearings.
- Schedule Independent Medical Exams when necessary.
- Review claims to determine if additional investigations such as surveillance are necessary and assign that surveillance,
- Provide monthly reports as defined,
- Assist with budgetary projections on the cost of the workers’ compensation program.
(2) All the questions must be submitted no later than September 30, 2019.

[C] Eligibility:

- Onshore (USA Only);

[D] Work Performance:

Not Applicable

Expiry Date : Tuesday, 15 October, 2019

Question Answer Deadline : Monday, 30 September, 2019

Category : Medical Billing and Coding

Country : USA

State : New York

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