Workers Compensation Claims Third Party Administrator (TPA)

City of Beaverton

Seeking informal proposals from qualified firms for services of a third-party claims administrator (TPA) to provide professional workers’ compensation claim processing services.

City of Reno

Administer city's workers' compensation claims program through its self-funded workers' compensation insurance program. Services requested include: Third-Party Administration (TPA) services, Managed Care or Preferred Provider Program Services, Bill Review and Re-Pricing Services, and any other miscellaneous services that may be beneficial to the City workers’ compensation program.

The Garden State Municipal Joint Insurance Fund ("GSMJIF"), NIP Group, Inc.

Workers' compensation claims third party administrator: 1. The reporting process should include automatic completion and statutory filing of the first report with a copy sent to the reporting location with the assigned claim number. 2. The adjusters will perform in-depth claims investigations on all lost-time claims and are required to complete an investigative checklist in a format approved by the GSMJIF which will be included in the claim file. All lost-time investigations will include a compensability determination; three-point contact within 24 hours of report with the injured worker, employer and treating physician; recorded statements of the injured worker (and witnesses as needed); third-party investigation; prior loss history and medical records; diligent monitoring of lost time; aggressive use of IME's, FCE's & FFD's; offset, lien & credit analysis and proper notification to excess carriers. 3. Each open claim must be reviewed no less than every thirty (30) days depending upon the nature and complexity of the claim. 4. Timely and appropriate referral of claims to designated network medical management providers. 5. All indemnity claims are to be reported to the Index Bureau upon receipt of first report and re-indexed every six (6) months for the life of the claim.