MB-3862 - USA (New Jersey) - Third Party Claims Administration and Managed Care Services - Deadline March 3,2020

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-3862

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

[A] Budget: Looking for Proposal

[B] Scope of Service:

Vendor needs to provide third party claims administration and managed care services.
- Reviewing call, the city claims forms submitted by the city and providing complete handling of all loss adjustment and medical case management in compliance with industry standards
- Establishing and maintaining estimated reserve figure for each claim file and consulting with the city with respect to payment of any claim
- Furnishing claim forms necessary for proper claims administration in accordance with the claim act
- Maintaining claim files for each reported claim throughout the life of the claim and to retain all closed files for a period of three years following closing of the file or as otherwise requires by applicable law or regulation
- Issuing checks in payment of benefits and allocated expense
- Attending any regularly scheduled city claim meetings to review claims
- Providing to the city written claims reporting procedures, including occurrences occurring after normal business hours, during holidays or on weekends
- Providing clinical review by an in-house medical director for complicated or severe and high cost cases, in conjunction with the approved medical service provider

[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 : Tuesday, 3 March, 2020

Category : Medical Billing and Coding

Country : USA

State : New Jersey

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