Posted Date : January 09,2019
Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID : MB-2752
Government Authority located in Nevada; USA based organization looking for expert vendor for worker compensation uninsured claims administration account service.
[A] Budget: Looking for Proposals
[B] Scope of Service:
(1) Vendor needs to provide worker compensation uninsured claims administration account service.
- Assume responsibility for the transfer from the previous vendor of all open and closed claims, while maintaining claim file completeness, coherence and integrity.
- Assume responsibility for management of all open claims as well as storage of all existing closed claims.
- Assume responsibility for all claims received after the effective date of the contract.
- Inform employers and injured employees of their rights and benefits under the workers’ compensation act and communicate with the injured worker on a regular basis throughout the duration of the claim.
- Review all forms, documents and reports, and obtain supplemental information, including conducting investigations, as necessary, to evaluate claims.
- Establish claim files containing complete claims documentation.
- Promptly review and determine the compensability of claims and appropriate benefits, in accordance with law.
- Promptly establish reserves on claims based upon medical and factual reporting, anticipated medical treatment, anticipated length of temporary disability, expected permanent residual impairment, age and occupation of the worker, anticipated pension or survivors’ benefits, and law.
- Promptly review, compute and pay all benefits, rating awards, life medical and life pensions, in accordance with law.
- Arrange and supervise rehabilitative programs, assigning rehabilitation service vendors when appropriate.
- Manage medical and vocational rehabilitative cases, in accordance with sound claims and medical practice.
- Investigate the causes of injury or illness, and recommend subrogation, with recommendation notification.
- Prepare files, submit documentation and vigorously represent at administrative hearings when required by DIR. This representation may not be conducted telephonically without prior approval.
- Provide hard copies of all requested claims documentation, correspondence and reports as well as electronic access as requested.
- Provide direct access to a claims examiner in the vendor’s office who is responsible for the administration of the uninsured claims.
- Provide electronic access between division on industrial relations and vendor for uninsured claims files. Electronic access will be at no additional charge.
- The vendor will perform other advisory and administrative duties to assist in the administration of the uninsured claims.
(2) All questions must be submitted no later than January 17, 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.
Budget :
Deadline to Submit Proposals: February 11,2019
Cost to Download This RFP/RFQ/RFI/Solicitation/Tender/Bid Document : 5 US$
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Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID : MB-2752
Government Authority located in Nevada; USA based organization looking for expert vendor for worker compensation uninsured claims administration account service.
[A] Budget: Looking for Proposals
[B] Scope of Service:
(1) Vendor needs to provide worker compensation uninsured claims administration account service.
- Assume responsibility for the transfer from the previous vendor of all open and closed claims, while maintaining claim file completeness, coherence and integrity.
- Assume responsibility for management of all open claims as well as storage of all existing closed claims.
- Assume responsibility for all claims received after the effective date of the contract.
- Inform employers and injured employees of their rights and benefits under the workers’ compensation act and communicate with the injured worker on a regular basis throughout the duration of the claim.
- Review all forms, documents and reports, and obtain supplemental information, including conducting investigations, as necessary, to evaluate claims.
- Establish claim files containing complete claims documentation.
- Promptly review and determine the compensability of claims and appropriate benefits, in accordance with law.
- Promptly establish reserves on claims based upon medical and factual reporting, anticipated medical treatment, anticipated length of temporary disability, expected permanent residual impairment, age and occupation of the worker, anticipated pension or survivors’ benefits, and law.
- Promptly review, compute and pay all benefits, rating awards, life medical and life pensions, in accordance with law.
- Arrange and supervise rehabilitative programs, assigning rehabilitation service vendors when appropriate.
- Manage medical and vocational rehabilitative cases, in accordance with sound claims and medical practice.
- Investigate the causes of injury or illness, and recommend subrogation, with recommendation notification.
- Prepare files, submit documentation and vigorously represent at administrative hearings when required by DIR. This representation may not be conducted telephonically without prior approval.
- Provide hard copies of all requested claims documentation, correspondence and reports as well as electronic access as requested.
- Provide direct access to a claims examiner in the vendor’s office who is responsible for the administration of the uninsured claims.
- Provide electronic access between division on industrial relations and vendor for uninsured claims files. Electronic access will be at no additional charge.
- The vendor will perform other advisory and administrative duties to assist in the administration of the uninsured claims.
(2) All questions must be submitted no later than January 17, 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.
Budget :
Deadline to Submit Proposals: February 11,2019
Cost to Download This RFP/RFQ/RFI/Solicitation/Tender/Bid Document : 5 US$