Elements and Performance Criteria

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.

Written and verbal instructions may include:
notices
telephone calls
insurance policy terms and conditions
claims notifications
investigation procedures.
Medical terminology may relate to:
knowledge of medical specialties and the names and titles of doctors working in specialist fields
illnesses
injuries
diseases
interrelated functions of the body, locations and diseases (e.g. functions of the skeletal system, locations of skeletal injuries, skeletal diseases)
terms to describe onset and/or nature of disease
medical investigations and procedures
abbreviations for medical and pharmacological terms.
Clarification may be sought from:
organisational policies, procedures and guidelines
insurance information/databases
medical dictionary
medical information sources/databases
Chief Medical Officer
a medical professional
a claims manager/specialist or designated supervisor
underwriter or underwriting specialist/manager.
Insurance-based communications may include:
contact with relevant internal or external parties
dealing with applicant, insured and claimant enquiries
letters in response to cover and claims queries
maintaining and/or updating claims files and databases (e.g. file notes, correspondence, reports)
memos and reports
researching and/or arranging medical or psychological assessments
researching and/or arranging treatment and rehabilitation.
An appropriate authority may include:
Chief Medical Officers
underwriters
underwriting specialists and managers
WorkCover representatives
medical professionals.

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:
interpret and respond to instructions containing commonly used medical terminology and abbreviations
maintain knowledge of medical terminology used in insurance contexts
use medical terminology appropriately in insurance contexts
explain medical terminology and processes in simple language.
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 records
access to organisational policies and procedure.
Method of assessment
A range of assessment methods should be used to assess practical skills and knowledge. The following examples 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
setting and reviewing workplace projects and business simulations or scenarios.
Guidance information for assessment