Third-Party Administrator (TPA) Services for CalAIM Healthcare Initiatives

The County of Shasta is seeking a Third-Party Administrator (TPA) to provide healthcare services associated with individuals under the supervision of the Shasta County Probation Department as part of the CalAIM Justice Involved Reentry Initiative. The TPA will be responsible for managing claims processing and adjudication, payment posting and reconciliation, denial and appeals management, reporting and data analytics, and compliance. The selected TPA will work closely with Shasta County Probation and its healthcare partners to ensure timely and accurate claiming for services, while maintaining high standards of confidentiality, accountability, and customer service. Some key responsibilities include: • Claims Processing and Adjudication • Payment Posting and Reconciliation • Denial and Appeals Management • Reporting and Data Analytics • Compliance The County is looking for a partner that can deliver efficient, compliant, and cost-effective administration of healthcare claims submission with adherence to all applicable federal, state, and local regulations.