MB-5833 - USA (Virginia) - Claims Management System - Deadline December 17,2021

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-5833

Government Authority located in Virginia; USA based organization looking for expert vendor for claims management system.

[A] Budget: Looking for Proposals

[B] Scope of Service:

Vendor needs to provide claims management system includes both paper files and electronic files that are managed in Risk & Wellness Services.
- Contractor to configure and deploy a modernized, paperless and cloud based claims system. The goals of this system are to:
· Improve efficiency of incident, illness, injury, accident and claim processing and handling;
· Eliminate duplicate claim entry and tracking;
· Improve data management by combining current incident, illness, injury, accident and claim processes into an electronic integrated system;
· Improve the quality and efficiency of reporting by combining claims data, standardizing claims reports, and identifying trends;
· Ability to connect data from other systems such as a Human Capital Management System (HCM);
· Ability to track financials for various insurance programs;
· Ability to track claim costs to include recoveries and subrogation payments;
· Ability to collect and track documents;
· Ability to track vehicle information;
· Ability to customize categories for tracking.
· Collect risk related information in a uniform manner and share the information with appropriate stakeholders.
- Operating System and Hardware Requirements: The application must be compatible with the existing hardware and platform.
- Automated Interfaces, Imports & Extract to/from third party systems: The system must have the capability to interface and exchange information with the Oracle Financial and Human Capital Management (HCM) system. This claims system will be used to interface with employee data and Financials. - Claim Administration Functionality: The PWSIG will only consider systems that have flexibility over the amount or number of data fields that can be built. The system must have true financial accounting for subrogation recoveries, credits or contributions and insurance recoveries, in addition to allocation/bill back to departments. The system must have the capability to customize data fields which includes department/division codes, locations etc.
- Data Conversion: The system must be able to convert the historical claim data into the system.
- Backup and Recovery: Vendors must have a sufficient back-up and recovery facilities with minimum time for copying and loading data. The proposed system must have adequate rollback features so that partially completed transactions that occur by system crashes are backed out.
- System must provide audit log of changes to records showing old value and new value, date of change, time of change, and the user who made the change.
- Describe minimal and optimal hardware configurations of server and client machines including:
· Processor type and speed
· Internal memory requirement
· Internal hard drive storage requirement
· Additional network drive storage requirement
· Operating system requirement
· Backup and recovery requirement
· Printers/scanner requirements
- Provide a system that will accommodate a minimum of 10 users in multiple locations and remote sites. Must have the ability to add claims and incidents from remote locations.
- Provide on-line, real time access to the system for inquiry, data entry, and file maintenance.

[C] Eligibility:

- Onshore (USA Organization Only);

[D] Work Performance:

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

Expiry Date : Friday, 17 December, 2021

Category : Medical Billing and Coding, Software, System and Application

Country : USA

State : Virginia

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