Workers Compensation Third Party Administrator

The City of Denton is seeking a Third Party Administrator (TPA) to provide claim management services for workers’ compensation. The TPA will be responsible for managing all claims utilizing a “best practice” approach, including claim setup and assignment, coverage determination, investigation, quality assurance, and settlement. The City requires the TPA to have a proven track record of using innovative approaches to providing goods and services that represent the best value to their clients. The TPA must also have the ability to accomplish all aspects of the requested services, including claim reviews, claim management philosophy, assignment of losses, investigation, and settlements. Some key points include: • Claim reviews: The City requires quarterly file reviews that will be coordinated and conducted by the TPA Account Executive (AE) or designee. • Claim management philosophy: The City requires the TPA to manage all claims utilizing a “best practice” approach in resolving each claim. • Assignment of losses: The TPA must have the capability to accept claim reports 24 hours a day, seven days a week, and have immediate responses when requested. • Investigation: The City believes that thorough investigations are necessary to document and protect evidence to determine compensability. • Settlements: The City prefers to settle claims based on a sound analysis of liability/compensability and damages, not merely based on cost of defense nuisance value.