Application
This unit describes the skills required to process compensation claims for employment related injuries. It includes confirming claim details, processing payments and maintaining files.
This unit applies to those working in public sector roles but may be applied to anyone working in a similar organisational context.
The skills and knowledge described in this unit must be applied within the legislative, regulatory and policy environment in which they are carried out. Organisational policies and procedures must be consulted and adhered to.
Those undertaking this unit would work independently, while performing routine tasks in a familiar context.
No licensing, legislative or certification requirements apply to unit at the time of publication.
Elements and Performance Criteria
ELEMENTS | PERFORMANCE CRITERIA |
Elements describe the essential outcomes | Performance criteria describe the performance needed to demonstrate achievement of the element. Where bold italicised text is used, further information is detailed in the range of conditions section. |
1. Confirm details | 1.1 Complete documents, and obtain authorisation/s for claims. 1.2 Assess the reasonableness of accounts to ensure accounts that are paid are relevant to disability. 1.3 Record account details. 1.4 Notify relevant personnel when accounts are rejected. |
2. Process payments | 2.1 Produce and post cheques or process electronic transfer of funds. 2.2 Batch accounts where required for traceability. 2.3 Confirm authorisations for periodic payments to avoid overpayments. 2.4 Process claims within time limits. |
3. Maintain files | 3.1 Maintain records. 3.2 Document all contacts. 3.3 Maintain evidence of file management for audit purposes. |
Evidence of Performance
Evidence required to demonstrate competence must satisfy all of the requirements of the elements and performance criteria. If not otherwise specified the candidate must demonstrate evidence of performance of the following on at least one occasion.
applying legislation, regulations and policies relating to processing of claims
recording and reporting of transactions
reading and interpreting claims information
checking the accuracy of calculations and reconciliations
assessing reasonableness of accounts
using communication including reporting of irregularities and errors
Evidence of Knowledge
Evidence required to demonstrate competence must satisfy all of the requirements of the elements and performance criteria. If not otherwise specified the depth of knowledge demonstrated must be appropriate to the job context of the candidate.
public sector legislation, including work health and safety and environment
regulations, and guidelines relating to injury management and processing claims
privacy legislation
procedures to ensure confidentiality and security of information
procedures for cash and non-cash handling
injury management claims relating to diverse disabilities
methods and techniques for simple numerical calculations
equal employment opportunity, equity and diversity principles
Assessment Conditions
This unit contains no specific industry-mandated assessment conditions. Guidance on suggested and recommended conditions and methods can be found in the Implementation Guide.
Assessors must satisfy the NVR/AQTF mandatory competency requirements for assessors.
Foundation Skills
Foundation skills are embedded within the elements and performance criteria of this unit.
Competency Field
Injury management