Insurance and Billing Administration

The contract requires end-to-end management of insurance claims and billing for mammogram services, with the sole objective of ensuring zero cost to the district and its employees. This includes the accurate and timely submission of claims to all relevant payers, including the State Health Plan, Medicare, and other private insurers, while maintaining full compliance with HIPAA regulations for the handling, storage, and transmission of protected health information. All processes must be designed to maximize reimbursement efficiency and minimize administrative burden on the district. The subcontractor is accountable for managing every step of the billing cycle, from initial claim preparation through adjudication and follow-up on denials or underpayments, without passing any expenses to the district or its staff. The work must be performed in strict accordance with federal privacy standards and industry best practices, ensuring the confidentiality and security of patient data at all times. The opportunity is posted under NAICS code 561410, indicating administrative and support services, and responses are due by June 18, 2026, with the contracting entity being GCS Administration under the South Carolina state jurisdiction.