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MB-3631 - USA (Virginia) - Claims Administration Services for Workers Compensation - Deadline January 6,2019

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-3631

Government Authority located in Virginia; USA based organization looking for expert vendor for claims administration services for workers compensation.

[A] Budget: Looking for Proposal

[B] Scope of Service:

(1) Vendor needs to provide claims administration services for workers compensation
- The County currently accepts employee claims through electronic mail, but is exploring telephonic and web-based intake processes, and will be reviewing modifications to their internal process,
- Contractor shall provide a secure e-mail address to receive the first report of injury and employee’s injury report, the Contractor shall establish and maintain a 24/7 toll free telephone number and optional web-based intake form for the reporting of workers’ compensation injuries,
- Claim numbers must be created by the Contractor,
- The claims supervisor reviews all County first reports of injury and assigns the claim to the appropriate claims adjuster,
- The claims adjuster shall verify the accuracy of data entry information as well as verification of the agency location, nature, and cause codes,
- . Open claims must be reviewed by a supervisor at least every thirty calendar days, documentation of the review must include comments in the electronic activity notes on reserve adequacy, verification of financial activity, and recommendations for future handling of the claim,
- Contractor must conduct continuous audits of claim files by adjuster and supervisor for benchmark milestones such as prompt contact, investigation, and compensability/liability decisions, prompt payments, proper statutory filings with the Workers’ Compensation Act and other criteria
to be determined,
- At time of closure, claims must be reviewed by a supervisor, documentation of the review must include comments in the electronic activity notes to confirm the validity of closure and claim coding, proper statutory filings with the act, and to reconcile financial activity to ensure appropriateness of payments.
(2) All the questions must be submitted no later than December 12, 2019.

[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 : Sunday, 6 January, 2019

Question Answer Deadline : Thursday, 12 December, 2019

Category : Medical Billing and Coding

Country : USA

State : Virginia

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