Unit of Competency Mapping – Information for Teachers/Assessors – Information for Learners

FNSISV310A Mapping and Delivery Guide
Process claims payments

Version 1.0
Issue Date: May 2024


Qualification -
Unit of Competency FNSISV310A - Process claims payments
Description This unit describes the performance outcomes, skills and knowledge required to generate and process claim related payments. It encompasses ensuring timeframes for payments are met and appropriate records maintained.This unit is applicable to individuals working within enterprises and job roles subject to licensing, legislative, regulatory or certification requirements including legislation administered by the Australian Securities and Investments Commission (ASIC).
Employability Skills This unit contains employability skills.
Learning Outcomes and Application This unit applies to job roles involving claim payment processing in a range of insurance sectors and may be applied within organisations of various sizes and across a range of customer bases.
Duration and Setting X weeks, nominally xx hours, delivered in a classroom/online/blended learning setting.
Prerequisites/co-requisites
Competency Field
Development and validation strategy and guide for assessors and learners Student Learning Resources Handouts
Activities 		Slides
PPT 		Assessment 1 Assessment 2 Assessment 3 Assessment 4
Elements of Competency Performance Criteria              
Element: Process payments
  • Payment information is identified, checked and accurately recorded
  • All payments are authorised in accordance with organisation operating procedures
  • Payments are generated as directed with reference to legislation, organisation policy and operating procedures and codes of practice, if applicable, within timeframes
  • Payment documents are completed identifying relevant details
  • Payment limits are observed for amounts requiring personal signing
       
Element: Notify reinsurer, if appropriate
  • Reinsurance information related to claims payment is checked
  • Where appropriate, reinsurers notified of claim payment amount and details under relevant reinsurance arrangements
       
Element: Finalise claims payment information to facilitate payment
  • Where required, payment information is finalised and entered on the system to prompt payment
  • Claims payment data and/or payments are dispatched within the required timeframe
  • Documents are copied and filed for auditing purposes according to organisation operating procedures
  • Interested parties are advised according to operating procedures where liability is not accepted
       


Evidence Required

List the assessment methods to be used and the context and resources required for assessment. Copy and paste the relevant sections from the evidence guide below and then re-write these in plain English.

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:

use detail and accuracy in following relevant legislation and organisation policy.

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

Submission Requirements

List each assessment task's title, type (eg project, observation/demonstration, essay, assignment, checklist) and due date here

Assessment task 1: [title]      Due date:

(add new lines for each of the assessment tasks)

Assessment Tasks

Copy and paste from the following data to produce each assessment task. Write these in plain English and spell out how, when and where the task is to be carried out, under what conditions, and what resources are needed. Include guidelines about how well the candidate has to perform a task for it to be judged satisfactory.

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 web-based 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

basic relevant accounting practice

relevant legislation, regulations organisation operating procedures and codes of practice

relevant taxation law, including Goods and Services Tax (GST) requirements

The range statement relates to the unit of competency as a whole. It allows for different work environments and situations that may affect performance. Bold italicised wording, if used in the performance criteria, is detailed below. Essential operating conditions that may be present with training and assessment (depending on the work situation, needs of the candidate, accessibility of the item, and local industry and regional contexts) may also be included.

Organisation operating procedures would specify:

authority levels

delegations

filing requirements

organisation accounting systems

other relevant details

payment process

timeframes.

Payment limits will be related to:

the authority limits and will vary from one organisation to another.

Reinsurers notified by:

raising a credit or a debit note.

Systems may be:

computerised, and data recording and updating may be electronic in the majority of cases.

Entering claims payment data may include:

coding according to organisation requirements (entering statistical data).

Documents may be:

hard copies/paper or they may be electronic.

Filing may be:

filing of hard copies or entry and storage in a computer system.

Copy and paste from the following performance criteria to create an observation checklist for each task. When you have finished writing your assessment tool every one of these must have been addressed, preferably several times in a variety of contexts. To ensure this occurs download the assessment matrix for the unit; enter each assessment task as a column header and place check marks against each performance criteria that task addresses.

Observation Checklist

Tasks to be observed according to workplace/college/TAFE policy and procedures, relevant legislation and Codes of Practice Yes No Comments/feedback
Payment information is identified, checked and accurately recorded 
All payments are authorised in accordance with organisation operating procedures 
Payments are generated as directed with reference to legislation, organisation policy and operating procedures and codes of practice, if applicable, within timeframes 
Payment documents are completed identifying relevant details 
Payment limits are observed for amounts requiring personal signing 
Reinsurance information related to claims payment is checked 
Where appropriate, reinsurers notified of claim payment amount and details under relevant reinsurance arrangements 
Where required, payment information is finalised and entered on the system to prompt payment 
Claims payment data and/or payments are dispatched within the required timeframe 
Documents are copied and filed for auditing purposes according to organisation operating procedures 
Interested parties are advised according to operating procedures where liability is not accepted 

Forms

Assessment Cover Sheet

FNSISV310A - Process claims payments
Assessment task 1: [title]

Student name:

Student ID:

I declare that the assessment tasks submitted for this unit are my own work.

Student signature:

Result: Competent Not yet competent

Feedback to student

 

 

 

 

 

 

 

 

Assessor name:

Signature:

Date:

Assessment Record Sheet

FNSISV310A - Process claims payments

Student name:

Student ID:

Assessment task 1: [title] Result: Competent Not yet competent

(add lines for each task)

Feedback to student:

 

 

 

 

 

 

 

 

Overall assessment result: Competent Not yet competent

Assessor name:

Signature:

Date:

Student signature:

Date: