Workers’ Compensation Claim Administration, Cost Containment, and 504 Network Program Administration Services for El Paso County, Texas

The El Paso County, Texas is seeking a Claims Administrator (Third Party Administrator or TPA) for its self-funded workers compensation program, a 504 Network Program and Cost Containment Services. The selected company or companies will be expected to commence service on January 1, 2026 for three years with the possibility of two one-year extensions. The scope of work includes claims administration, cost containment services, and 504 network program administration. The County is looking for a vendor that can provide a seamless process for both internal operations and injured employees, as well as maximize the timely delivery of health care services. • Claims Administration: includes payment and adjusting, claims investigation, establishing reserves, medical reviews, medical case management, early intervention, defense of denied claims, and claims management reports. • Cost Containment: includes auditing medical bills and pre-authorization of medical services with the ability to adhere to 504 pre-authorization guidelines. • 504 Program Administration: includes administering and providing a panel of medical providers contracted to provide quality care with appropriate utilization and return to work.