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Challenge
Faced with a growing number of benefits claims, as well as complying with new federal regulations, the South Carolina Employment Security Commission needed a solution to process claims efficiently while meeting compliance requirements.
Solution
The Commission implemented G360 Enterprise BPM as an enterprise solution to facilitate storage and retrieval of more than 10,000 electronic items each day.
Return on Investment
The Commission is able to process twice as many claims with about 25 percent fewer people while improving customer service and response times. State government organizations often find themselves pulled in one direction-by constituents with growing expectations — while being pushed in another — by federal government regulations and mandates. With tighter budgets and limited staff, keeping up with the demands on both ends can be a daunting challenge. But as the South Carolina Employment Security Commission has discovered, a business process management (BPM) solution from Global 360 provides the way to meet this challenge head on.
"We're processing double the number of benefits claims today than we were just three or four years ago," says Richard Cheatham, Manager of Imaging Services at the Commission. "New federal regulations have also added several new steps that are required to process each claim. Global 360 enables us to handle the increased volume and comply with the regulations, while enhancing the quality of our claims process and providing improved service to our citizens."
Integrating Global 360
The South Carolina Employment Security Commission implemented Global 360 as an enterprise solution for the entire unemployment insurance program. It spans benefits, tax, quality control, appeals and field service, even extending outside the Employment Security Commission's central office complex to the Commission's local field service offices. The entire organization takes advantage of the rapid storage and retrieval capabilities provided by Global 360. In addition, the Benefits group has made extensive use of G360 Reports Manager.
The Commission receives over 10,000 electronic items into the system every day, including claims, and quarterly contribution and wage reports from employers in the state.
Contribution and wage reports are processed by a mainframe application and sent in batches to the Global 360 (COLD) server, which produces a formatted electronic document that is stored in each employer's file. Any other documentation that is received in paper form, including benefits information and claims, is scanned into the imaging system and routed to the appropriate file.
"We have customized our application to create workflow work items directly from COLD documents," states Cheatham, "allowing COLD output to be routed automatically, along with any associated images.
So users can see COLD items and images side by side in a single interface, which makes it a lot easier for our service reps to answer questions — because they have more complete information."
The Commission is also in the process of extending its COLD application to handle benefit checks coming in from the bank. This additional capability will automate the processing of over 250,000 documents per month, eliminating any need to scan the paper checks — saving another step and further reducing overhead.
Streamlining Claims Processing
In the benefits area, the Commission has used Global 360 to streamline claims processing and accelerate payments — better serving people in need, while adhering to federal regulations.
There are many different types of claims filed, each with numerous parameters and requirements that must be met for the benefits to be properly administered. Global 360 enables multiple processes to be performed in parallel so that all the necessary information can be determined in a timely manner.
"Prior to adopting workflow, running parallel processes wasn't possible," explains Cheatham. "Today, multiple individuals can access the same electronic files. So one person can determine eligibility based on the separation circumstances, and another can simultaneously determine eligibility from a financial standpoint. It's had a significant impact on efficiency."
Increased efficiency is always a desirable benefit. But with new federal government requirements for processing claims, it has been critical.
"We have always had a time limit for processing claims," says Cheatham. "With the newer regulations, we now also have additional steps that must be factored in. For example, during the adjudication process, we are required to contact both the employer and the claimant and provide them with an opportunity to provide additional separation information, if necessary. By having all information available on-screen, we can do this quickly over the phone. As a result, we can ensure the highest quality in our claims process and still meet the time requirements."
In recent years, with more individual filing for unemployment benefits, streamlining the claims process has really paid off. In fact, the Commission is able to process twice as many claims with approximately 25 percent fewer people than were needed during a comparable economic downturn in the late 1970s.
Enhancing Customer Service
The primary objective at the Employment Security Commission is to provide better service to the citizens of South Carolina. The Global 360 solution has enabled the Commission to meet that objective. Because the workflow tracks documentation throughout every step in the process, service representatives have more complete information instantly available on-screen to handle inquiries regarding a particular claim. This is a dramatic improvement over the days when documents were stored on microfiche.
Richard Cheatham explains: "When someone called in to talk about a claim prior to having the imaging capability, our representatives would have to take down their name and phone number, then call back later. If the claim was on paper, a request would be sent for a clerk to pull the folder and make copies; otherwise, we'd have to go down and search through the microfiche and make a copy of the record. We might get back to the caller that day; we might not. But now, information can be retrieved in just a few seconds."
Service has also been enhanced for the state's employers. With everything in electronic form, should an employer call in to discuss a matter with one of the consultants in the tax department, that consultant can instantly pull every record available on the employer. It has enabled the Commission to be highly responsive, creating a satisfying experience for both Commission employees and the people they serve.
While improved process efficiency has been a boon to service quality, the Commission has also realized financial benefits. "As the Global 360 system has grown and matured," concludes Cheatham, "we've seen a return on investment not only in terms of better customer service and efficiency, but also in raw dollar savings."
Solutions
G360 Enterprise BPM
Application
Claims Processing
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