Third-Party Workers’ Compensation Claims Administration and Managed Care Services
Overview
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SUMMARY
KEY REQUIREMENTS
CONTRACT DURATION
TIMELINE
Release RFP: September 16th, 2026
Final Day to Submit Questions: September 30th, 2026
Responses to Questions posted on BidsOnline: October 7th, 2026
RFP Responses Due from Bidders: October 14th, 2026
Final Selection and Contract Negotiations: October 2026
City Approval Processes: November/December 2026
Effective Date of Contract: January 1st, 2027
QUESTION DEADLINE
CONTACTS
Primary procurement contact — name, title, email, and phone
Additional decision-makers and their departments
Issuing Agency
City Of Richmond
DESCRIPTION
The agency seeks a qualified vendor to provide third-party workers’ compensation claims administration and managed care services in accordance with the California Labor Code. Claims administration responsibilities include determining liability and eligibility, authorizing medical and indemnity benefits, processing approved ratings, findings, awards, and settlements, arranging informal disability ratings when appropriate, and paying applicable penalties. The vendor must establish and maintain claim files containing medical, factual, and accounting information in accordance with statutory requirements.
The selected provider will review medical bills for compliance with applicable fee schedules and network requirements, identify duplicate or unauthorized charges, and deny charges unrelated to the reported injury or treatment plan. Utilization review services must include timely approval or denial of service requests, medical guidance as appropriate, reporting to the agency on requests, decisions, costs, and savings, and recommendations for medical professionals, specialists, and treatment facilities.
The vendor must also provide telephonic and field nurse case management, maintain communication with treating physicians, support proactive claim management, and promote return-to-duty when clinically feasible. Claim documentation must reflect significant developments and include a current plan of action for each file.
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Frequently asked questions
- When is the submission deadline?
- Submissions are due October 14, 2026. Questions must be submitted by September 30, 2026.
- Who issued this RFP?
- It was issued by City Of Richmond. The work is located in Richmond, California, United States.
- Who is a good fit for this opportunity?
- Experienced third-party workers’ compensation claims administrator
- Demonstrated knowledge of California Labor Code and workers’ compensation requirements
- Integrated bill review, utilization review, and managed care capabilities
- Licensed or credentialed nurse case management professionals for telephonic and field services
- Proven experience managing claims documentation, payments, settlements, and regulatory reporting
Analysis generated by Settle AI from the source RFP.
RFP Hunter shows what is open. Settle shows what is forming.
Settle pieces together buyer signals, budgets, contract activity, and the sources your team already monitors. See why an opportunity fits and what to do before the RFP posts.