Pensions and Retirement Training Course on Claims Processing Procedures

Module 1: Overview of Pension Claims Processing
Introduction to claims processing and benefit administration principles
Types of claims: retirement, death, disability, and withdrawal benefits
Key stakeholders in claims management (members, employers, trustees, insurers)
The importance of accuracy and transparency in claims handling
Case study: Evaluating delays in pension claim settlements

Module 2: Documentation and Verification Procedures
Required documentation for various claim types
Identity verification, beneficiary validation, and legal compliance checks
Managing incomplete, incorrect, or fraudulent claim submissions
Developing documentation checklists and approval hierarchies
Workshop: Designing a claims verification template

Module 3: Workflow Design and Process Optimization
Mapping the claims process from initiation to disbursement
Roles and responsibilities in claims approval chains
Workflow automation and system integration with pension databases
Identifying process bottlenecks and implementing solutions
Practical exercise: Simulating an end-to-end claim process

Module 4: Compliance, Risk, and Quality Assurance in Claims Management
Regulatory and scheme-specific requirements for claims settlement
Internal controls, audits, and risk mitigation strategies
Timeliness and service-level agreements (SLAs) in claims processing
Handling disputes, appeals, and rejected claims professionally
Case study: Improving claims turnaround through compliance audits

Module 5: Digital Transformation and Member Communication
Digitalization of claims processing: online submissions and e-verification
Using dashboards and workflow systems for claim tracking
Communicating claim outcomes and payment timelines transparently
Leveraging analytics for monitoring claim patterns and fraud prevention
Capstone workshop: Developing a digital claims processing improvement plan