Workers’ Compensation Conflict of Interest Claims Third-Party Administration Service
Location:
California, United States
Posted on:
Deadline:
Summary:
Seeking a consultant to provide third-party administration for conflict-of-interest workers’ compensation claims in California, including comprehensive claims management, medical oversight, and bill review.
Get full access to this RFP
Download the full RFP document and use Settle's AI to analyze requirements, estimate budget, and draft winning responses in minutes.
The contractor is required to deliver comprehensive workers’ compensation conflict-of-interest claims third-party administration services. This includes management of claims that are currently closed, previously closed, and any claims that may reopen during the agreement term. The scope encompasses drafting specific written policies and instructions to clarify all requirements and procedural standards for claims management.
Additionally, the consultant will monitor treatment programs to ensure employees receive appropriate medical care, determine eligibility for and authorize temporary disability compensation benefits based on medical advice and rehabilitation efforts, and conduct bill reviews to demonstrate timely approval or objection to bills. The consultant must utilize their own licensed internet valley oak systems (iVOS) for effective claim file management.
The contract period is set for three years. Questions regarding this RFP must be submitted by March 11, 2026, and a pre-proposal meeting will be held on March 4, 2026.
