Case: Study: Redesigning Claims Associate Onboarding
in the Insurance Industry
Executive Summary
In the highly regulated and fast-paced insurance industry, claims associates serve as a critical link between patients, providers, and the company. Their ability to process claims accurately and efficiently directly impacts customer satisfaction, provider reimbursement, and regulatory compliance. A TrainingPros’ leading insurance client identified gaps in its existing new hire training (onboarding) for claims associates—an outdated, paper-based program that lacked consistency, accessibility, and engagement, especially in a remote work environment.
To address this challenge, the insurance company partnered with TrainingPros to provide experienced instructional design consultants to lead the end-to-end redesign of their claims associate onboarding. The goal: to build a modern, engaging, and scalable training solution that would increase speed to proficiency, improve quality, and enhance learner engagement across a geographically dispersed workforce.
TrainingPros consultants worked alongside internal stakeholders to conduct a thorough needs analysis, modernize the curriculum, and deliver a blended learning program using best-in-class instructional strategies. Key components included eLearning modules, simulations, digitized guides with live resource links, gamification, and enhanced on-the-job training (OJT). The redesigned program was piloted with great success, showing measurable improvements in learner performance, supervisor satisfaction, and internal promotion rates. The collaboration exemplifies how strategic partnerships and expert consultants can drive real business outcomes in the insurance industry.
The Challenge
Prior to 2020, the insurance company delivered its claims associate onboarding entirely through in-person, instructor-led training. This legacy program was maintained locally by facilitators in various regions and heavily reliant on paper-bound guides and live access to systems. While functional for a co-located workforce, the sudden shift to remote work during the COVID-19 pandemic exposed several critical shortcomings.
The paper-based curriculum was not designed for virtual delivery. Activities intended for in-person participation lost their impact in remote sessions. Facilitators across different locations used slightly different versions of the materials, leading to inconsistent delivery and uneven learner outcomes. Furthermore, the guides that once served as reference tools became less accessible to remote learners, who no longer had immediate floor support from supervisors or trainers after transitioning into their roles.
Additionally, the support documents used by claims associates were often outdated, difficult to read, or not aligned with training materials. Given that the support materials are essential for processing claims accurately under various policy and product scenarios, this disconnect was a major barrier to quality. As healthcare policies and insurance regulations changed rapidly, the training failed to keep pace.
These training deficiencies had significant downstream effects. New hires took longer to reach proficiency, error rates increased, and learners lacked confidence. Facilitators often had to fill gaps on the fly, bringing in subject matter experts (SMEs) to explain updates not reflected in the curriculum. With over 46 million claims processed annually, even small inefficiencies compounded quickly.
The insurance company recognized the need for a foundational overhaul of its claims associate onboarding. They needed a solution that could scale across time zones, function in a remote setting, and prepare learners to progress from entry-level claim tasks to more advanced responsibilities efficiently.
The Solution
To meet these challenges, the insurance company engaged TrainingPros to provide seasoned instructional design consultants who would lead the transformation of their claims associate onboarding. The consultants collaborated with the company’s talent development team, claims operations leadership, facilitators, SMEs, and union representatives to execute a full-scale needs analysis and curriculum redesign.
Needs Analysis and Discovery
TrainingPros consultants began by reviewing existing materials, including participant and facilitator guides, legacy activities, and evaluations. They conducted extensive stakeholder interviews—ranging from current and former claims associates to training managers, supervisors, and union representatives.
The findings were clear:
- The existing program lacked alignment with real job tasks.
- Learning resources were not current or easily accessible.
- Instructional strategies needed to evolve to suit remote learners.
- Training had to promote consistency across union and non-union environments.
Curriculum Design and Development
Armed with insights from the analysis, the consultants developed a four-week blended learning program tailored to remote delivery. Key features included:
- Self-Paced eLearning: Foundational knowledge about insurance products, terminology, and claims workflows was delivered through interactive eLearning modules.
- Interactive Simulations: Given the lack of system sandboxes, realistic simulations were created to allow learners to observe and practice tasks in a safe environment.
- Digitized Participant and Facilitator Guides: These interactive PDFs included embedded links to over 60 updated procedures, space for notes, and visuals that enhanced usability.
- Gamification: Tools like Kahoot! quizzes, Jeopardy-style reviews, and scavenger hunts were used to reinforce learning and improve engagement.
- Scenario-Based Vyond Videos: These animated, persona-driven videos helped bring complex concepts to life, giving learners a visual and contextual understanding of policy applications.
- Enhanced On-the-Job Training (OJT): A two-week OJT component followed classroom training, combining live claim processing, virtual shadowing, and structured evaluations using a new performance tracking spreadsheet.
The TrainingPros consultants also delivered a Train-the-Trainer (T3) program to prepare facilitators to lead the redesigned sessions. Instructional designers observed the pilot delivery live and gathered detailed feedback to further refine the experience.
The Result
The pilot cohort included 12 external hires located across multiple states and time zones. None had prior claims experience. The results were both measurable and meaningful:
- Learner Satisfaction: Participants reported higher satisfaction with the content and felt more confident in their ability to perform job tasks compared to legacy cohorts.
- Facilitator Usability: Instructors praised the ease of navigation and quality of the new materials.
- Supervisor Observations: Supervisors noted a faster ramp-up time, fewer processing errors, and higher engagement levels.
- Operational Improvements: The average time to proficiency decreased significantly, with claims being processed more accurately and quickly.
- Promotion Readiness: Impressively, 75% of pilot participants were promoted to the next level of claims processing faster than peers trained under the previous curriculum.
Perhaps most notably, the integration of refreshed procedures into the training and daily workflow led to greater consistency and accuracy across all locations—an essential goal for a distributed workforce. The redesigned program provided a cohesive and standardized onboarding experience regardless of facilitator, location, or learner background.
By leveraging the expertise of TrainingPros’ instructional design consultants, the insurance company achieved a modern, learner-centric, and performance-driven onboarding program. The collaborative effort demonstrated how targeted consulting support can produce lasting organizational impact—improving employee performance, enhancing customer service, and supporting long-term business goals.
Resources Provided
Technology Used
7 Key Design Elements of Successful Onboarding Programs
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