Workers Compensation Claims Management Services
Overview
Fit Score
Settle Intelligence
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SUMMARY
DESCRIPTION
The agency seeks a vendor to provide comprehensive workers compensation claims management services. This includes claim administration, management, investigations, and adjustment services necessary for effective handling of a self-insured workers compensation program.
The vendor will ensure timely and appropriate care for injured workers through in-network providers and emergency facilities, without the need for prior approval in emergency situations. Services must enable the agency to report claims 24/7/365 and access care seamlessly, including emergency care. Responsibilities also include thorough investigation of all reported claims, full claims processing, and providing accurate claim information and case notes via an online system that is available around the clock.
Additional requirements include supporting agency personnel during business hours (Monday to Friday, 7AM–6PM CST) for ongoing communication, and the coordination of medical bill review and medical cost control initiatives to promote efficient program operation.
Source attribution
This Settle analysis is based on the issuing organization’s public RFP listing.