As costs of health care increase, the claims processing divisions of insurance companies become especially diligent at trying to improve operating efficiencies and ensure accurate claims payments. In addition to reviewing the technical aspects of their systems, many companies are revisiting the recruitment, selection and training of personnel using these systems.
A case in point is the Plainville, Connecticut-based Connecticut General Life Insurance Co., a CIGNA company. The organization found problems in its selection process for benefit analyst/claims processors. For example, potential employees frequently weren't well-acquainted with the job for which they applied, so some applicants decided during or shortly after training that the work wasn't what they wanted to do. This led to unacceptably high turnover.
Interviewers also rejected some applicants because of poor interpersonal or English-language skills, which might have had no bearing on their abilities to perform claim-processing work. Claims analysts need skills in analysis, comprehension and mathematics, which aren't assessed best during verbal interviews.
Connecticut General needed a hiring system that would allow the company to gather as much information about candidates as possible. In addition, it wanted a hiring tool that would be valid, reliable, easy to use, self-scoring, job relevant and non-intrusive. What Connecticut General found was the Claim Processing Proficiency Assessment (CPPA), developed by New York City-based Q Technologies in conjuction with the CIGNA home office training department.
The system was designed to be used in reviewing various kinds of insurance-processing work. The assessment tool requires no more than an IBM XT-class microcomputer to operate, and uses computer screens to offer testing precision previously unavailable.
CPPA uses fact-based scenarios. Because claim processing work requires both intellectual (comprehension, coding, calculation) and athletic (typing speed and accuracy) skills, the system tests ability to determine how to process a claim document, as well as ability to type the information. Also, the system records precision and volume by measuring how well an applicant processes claims and how many he or she can process during a given time. The mixture of thinking and typing required of claims processors was considered during development of the system. The validity and reliability of applicant scores is determined by actual job content: Performance expectations are based on the company's best operators.
New employee turnover in the Plainville operation was eliminated after the program was implemented, which saved about $300,000 in training costs during the first quarter. Before implementation, 15 to 30 employees were hired per month, at a cost of approximately $5,000 per employee (including compensation and benefits) for the 90-day training program. …