Re-design all the processes related to
the adjudication of non-monetary
issues, from scheduling the
fact-finding activities to performing
all the clean up work required once the
non-monetary determination is made.
Eligibility Issues are identified in
the rules engine based on responses
from the claimant in the intake,
certification and other processes.
Issues can also be entered into the
system based on outside information -
phone call, etc. When these issues are
identified, they need to be adjudicated
and resolved before payments can be
made to the claimant. The application
shall assign cases to adjudicators and
schedule interviews with claimants. It
shall provide a place for adjudicators
to record pertinent information as well
as a means for the adjudicator to submit
and mail the final determination to the
claimant and/or employer. In addition,
the application shall provide an
efficient means for performing the
follow-up work required as a result of
the determination, including releasing
appropriate payments, setting up
overpayments, marking wages, removing
holds, setting up overpayments, etc.
including, where necessary, supervisory
review functionality. The application
shall also include the issuing and
mailing of mass determinations. A mass
determination is a single determination
on an issue affecting a number of
claimants who worked for the same
employer.
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