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MB-3776 - USA (Washington) - Independent Claims Audit Services - Deadline January 31,2020

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-3776

Government Authority located in Washington; USA based organization looking for expert vendor for independent claims audit services.

[A] Budget: Looking for Proposal

[B] Scope of Service:

Vendor needs to provide independent claims audit services is to evaluate the pool’s claims handling to determine if the processes are working efficiently and effectively, based upon industry best practices and state law, and/or identify potential areas where improvements are needed.
- Claims administration program to claims filing procedures and forms, standards requiring that case reserves for each claim be established in the amount of the jury verdict value, standards requiring case reserves be reviewed every ninety days, or when reasonably practicable, and such review is documented in the claim’s diary, standards requiring appropriate adjuster workloads, standards requiring claims payment procedures include sufficient internal controls to ensure adequate review and approval by claims management staff, standards requiring file documentation be complete and up to date, standards requiring timely and appropriate claim resolution practices, standards requiring opportunities for recoveries be reviewed and documented for each claim, standards requiring compliance with internal revenue service (IRS) rules for regulations, standards requiring that claims files be audited on the following categories: staffing, caseloads, supervision, diary, coverage, reserves, and promptness of contacts, field investigations, file documentation, settlements, litigation management and subrogation.

[C] Eligibility:

- Onshore (USA Only);

[D] Work Performance:

Performance of the work will be Offsite. Vendor needs to carry work in their office location

Expiry Date : Friday, 31 January, 2020

Category : Medical Billing and Coding, Auditing, Finance and Accounting

Country : USA

State : Washington

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