Health Insurance Claims Processing Services

The contract encompasses the end-to-end processing of health insurance claims for the U.S. Embassy in Kinshasa, covering adjudication, payment disbursement, denial management, and financial reconciliation. The service provider must ensure strict adherence to performance benchmarks, including settling at least 90 percent of claims within five business days and maintaining a denial rate no higher than five percent. All operations are to be conducted in Kinshasa, with the Department of State as the overseeing agency under the NAICS code 561410, which pertains to administrative management and general management services. The opportunity is structured as a subcontract, with responses due by July 25, 2026, and is open for bidding under a solicitation initiated on June 25, 2026. The contracting entity does not specify a set-aside for small businesses or other categories, and no point of contact details are provided in the public listing.