Required skills

communication skills to

determine and confirm information using questioning and active listening as required

relate to customers

liaise with others share information listen and understand

use language and concepts appropriate to cultural differences

numeracy and IT skills to

perform calculations related to achieving required outcomes

use computer applications word processing spreadsheet database specific purpose computer systems to assist in achieving required outcomes

access and update records electronically

access webbased information services

literacy skills to read and interpret documentation from a variety of sources and record and consolidate relevant related information

research and analysis skills for accessing and interpreting relevant information

organisational skills including the ability to plan and sequence work

Required knowledge

accountability requirements

IT and communications systems

level at which claims should be referred to senior staff

organisation policy and procedures

policy coverage interpretation and application

principles and methods of filing

product knowledge

relevant industry legislation and regulations

The Evidence Guide provides advice on assessment and must be read in conjunction with the performance criteria required skills and knowledge range statement and the Assessment Guidelines for the Training Package

Overview of assessment

Critical aspects for assessment and evidence required to demonstrate competency in this unit

Evidence of the ability to

accurately process claims across a representative range of products clients and conditions

apply organisation policy and procedures and comply with legislation and regulations and industry codes of practice

Context of and specific resources for assessment

Assessment must ensure

competency is demonstrated in the context of the work environment and conditions specified in the range statement either in a relevant workplace or a closely simulated work environment

access to and the use of a range of common office equipment technology software and consumables

access to organisation records

access to organisation policies and procedures

Method of assessment

A range of assessment methods should be used to assess practical skills and knowledge The following examples in combination are appropriate for this unit

evaluating an integrated activity which combines the elements of competency for the unit or a cluster of related units of competency

observing processes and procedures in workplaces

verbal or written questioning on underpinning knowledge and skills

evaluating samples of work

accessing and validating third party reports

Guidance information for assessment

Claims information may include:

Entering claims data may include:

Systems may be:

Organisation procedures may include:

Claims checking may include:

Specialists may include:

Referral procedures may involve:

Registering claims may involve:

Decision making process may involve:

Files may be: