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Third Party Administrator for Workers' Compensation

Publication Date
06/13/2018 02:20 PM EDT
Closing Date
06/26/2018 05:00 PM EDT
Issuing Organization
City of Omaha
Solicitation Number

Specifications include, but are not limited to: This RFP is designed to solicit proposals from qualified Workers’ Compensation Administrators. The required scope of work by the Workers’ Compensation Administrator must include, without limitation: Responsible for the intake and management of every City of Omaha injury. In conjunction with the Nurse Case Manager (NCM), if appropriate, the claims adjusters monitor each injury claim with the objective of returning the injured employee to work as soon as is medically possible following the injury. If such injured employee is unfit to work in a full-duty capacity, the claims adjuster will work closely with the injured employee’s supervisor for a limited-duty position within the injured employee’s medical restrictions. In order to meet this objective, the claims adjustors must be completely familiar with the fine details of each injury, and must work directly with the injured employee and medical providers. They must also be familiar with the requirements of the State of Nebraska Workers’ Compensation Statutes, and keep current and timely on all filings required by the State of Nebraska. They must work with the CITY’s Human Resource Workers’ Compensation and Safety Manager and the CITY’s Law Department to provide information and documentation to assist with the processing of litigation of the CITY’s claims. The specific duties of claims administration are as follows: 1. Accept injury reports via a 1-800 number staffed twenty-four (24) hours a day with trained professionals. 2. Evaluate any open claim and make recommendations to the CITY as to their proper disposition in accordance to the Workers’ Compensation Act or where applicable. 3. Maintain complete records (hard copy and/or computerized) on all reported claims. 4. Submit a monthly billing of expenditures to the CITY. 5. Prepare and deliver appropriate benefit payments (Medical & Indemnity) utilizing a payment method agreed upon with the CITY. Currently, the Workers’ Compensation Administrator withdraws claim payments from a CITY-owned bank account on a daily basis. The Workers’ Compensation Administrator is responsible for notifying the CITY when the bank account needs refunding. Please confirm your ability to duplicate the current process or provide a detailed description of your standard benefit payment process. 6. Calculate indemnity payments on a bi-weekly basis required by the Workers’ Compensation Act and provisions in the collective bargaining agreements. Submit these indemnity calculations to the Human Resources Department for payment. Please confirm your ability to duplicate the current indemnity calculation process or provide an alternate indemnity payment process.

https://www.douglascountypurchasing.org/current-requests-for-bids-a-proposals (opens in a new window)

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