Specifications include, but are not limited to: 1. Accept injury reports via a 1-800 number staffed 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) utilizing a payment method agreed upon with the CITY. (The CITY’s preference is for the vendor to pay all self-funded claims out of your own funds throughout the month and then bill the CITY at the end of the month.) Currently, medical bills relating to the injury are processed by CorVel, a TPA approved by the Nebraska Workers’ Compensation Court, with whom the CITY contracts. The CITY reimburses CorVel via ACH to fund these medical bills on a weekly basis, with CorVel then submitting payments to the appropriate providers. This arrangement is not expected to be duplicated. The CITY will consider other bill payment options. 6. Calculate indemnity payments on a bi-weekly basis required by the Workers’ Compensation Act and provisions in the bargaining unit contracts. Submit these indemnity calculations to the Finance Department for payment. 7. Stay in contact with physicians and other involved medical personnel as required to maintain a current perspective on the claimants’ progress toward his/her return to work. 8. Maintain contact with injured employees/retirees. 9. Keep current on the claimant’s treatment plan and on any barriers to the expected return to work date. 10. Prepare reports as required by the CITY for presentation at monthly Workers’ Compensation meetings. 11. Attend case management discussion along with case managers to review cases of a complex nature and/or cases which require team decisions and thought. (Duration of meetings are to be held either in person or remote. 12. Prepare in whole or in part (along with case managers) letters to physicians, letters regarding IME’s or other documentation requiring a medical perspective.
