Workers Compensation Claims Third Party Administrator Services

The Vendor is required to provide management services for a workers’ compensation function that supports and assists a highly proactive approach to injury and claims management.
- TPA will provide a comprehensive suite of services related to the management of workers' compensation claims.
- Claim intake and acknowledgment: prompt acknowledgment of claims within 24 hours of receipt and thorough investigation to obtain all necessary information.
- Claims management: comprehensive management of claims from inception through closure, including:
• Initial claim evaluation and determination of compensability.
• Coordination of medical treatment and rehabilitation services.
• Monitoring and managing temporary total disability (TTD) and permanent partial disability (PPD) benefits.
- Claims administration: maintain timely communication with the county, injured employees, and healthcare providers, including:
• Weekly updates on claim status.
• Notification of any litigation matters.
• Engagement of specialized resources as necessary (vocational rehabilitation, etc.).
- Reporting: monthly reporting of claims metrics, financials, and any outstanding claims issues, including but not limited to:
• Claim loss runs and trending analysis.
• Metrics indicating the effectiveness of return-to-work programs.
• Compliance with state-mandated reporting requirements.
• Loss run summaries and check log will be provided monthly.
- Collaborate return-to-work program: collaborate with the county's risk management department to support employees' safe reintegration into the workplace.
- Liability management: actively manage claims exposure and reserve allocations.
- Provide recommendations to mitigate future liabilities.
- Training and support: offer training sessions to county employees on workers' compensation policies, procedures, and the claims process.
- Contract Period/Term: 3 year
- Questions/Inquires Deadline: April 4, 2025