Workers Compensation Claims Administration Services

The Vendor is required to provide workers compensation claims administration services for include:
• Administration shall consist of third-party administration, case management, claims monitoring, managed care, and utilization review services.
• These services include: receipt, processing, filing, and maintenance of all claims-related forms, reports and notices as required by state law and the department of industrial accidents as needed for controlling loss; verification of all medical billings and determination of the state authorized rate for payment; timely follow-up with physicians and claimants and investigation of cases, when necessary, to reduce exposure and cost; recommendations of appropriate salary payments for final decision by the city.
• Administration may also include incorporation of nursing or other professional medical services to provide advice and assist in communication.
• The service provider will maintain frequent personal contact via telephone, email, and visits with the director or designee as needed to coordinate all information, actions, and decisions.