# Employer Assessment Tests



## sprkysgirl

I am probably going to open up a can of worms here but I am personally fed up with employer tests that they require you to take. I am no longer going to do these and am hoping some more of you jump on the band wagon. Now with that being said here are my reasons:

1st they only tell you whether you passed or failed and don't give you a chance to rebuttal any wrong answers.

2nd who created these tests and are the people who check the test qualified enough to tell me that I am wrong?

3rd whenever there is a human factor we the coder should be able know what our score was and what areas we bombed in.

4th some of the questions on these tests have nothing to do with what they are hiring for so what sense does that make, if your hiring for a provider outpatient coder why are you testing me on ER? Stick to what you are hiring for!

5th some of these tests are long and can take many hours and we do not get paid for taking them, my time is worth money.

I could go on and on but I am no longer going to work for any company that requires these stupid tests, if my experience can't stand on it's own then I don't want to work for you.

enough said!! Tell me what you guys think?


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## alysn1drlnd

I say AMEN! I have also passed these tests, that had nothing to do with what I was to be hired for, only to be told, I don't have the proper credintials! So did I just code your cases for you for free, or was it really a test lol..and further more, my resume shows my credentials, so why did I just spend hours taking this test if I did not have what you were looking for!

Thanks for the chance to vent with you! I feel better now.


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## em2177

I agree! I was asked to take a very lengthy test. After I was finished I was told that I "passed" but no score was given. The next day I was told that there were no longer any open positions. Interesting to say the least..... So, I just wasted 4 hours of my time for nothing!


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## mitchellde

sorry I disagree.  The pre-employment test are a way for the employer to gauge your expertise.  They are looking at many things while you take the test, how long you took for each question, how you arrived at  your answers, your body language.  All these and more communicate to the employer who you are as a coder and an employee.  So while you may have "passed" the test with correct answers you may have "failed" the interview with the way you answered.  I am a big supporter of these tests and I have no problem taking them, I usually explain my answers though even if they are multiple choice.  The multiple choice questions I can tell if they are working from older knowledge and the fill in the blank I want them to have my logic so I always include an explanation.


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## em2177

The test that I was asked to take was not timed and it was done remotely....


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## mitchellde

Even though it was not timed per se I would be willing to bet that the amount of time taken was part of the consideration.


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## Pam Brooks

I'm with Deb on this one. As a coding manager who administers coding tests, it's not just the score that I consider when I utilize this tool for selecting a new employee.

This is an opportunity for me to observe the candidate at work....do they look up the codes appropriately (in other words, do they go right to the tabular index, or do they look up the alpha index first?) I watch their demeanor.....obvious frustration or anger means that the stress of this job is going to be challenging. Do they appear confident, or are they flipping around in the books? Are they making notes on the op report? Basically, I need to see "how" these candidates work. I do look at the test answers, but they don't ever determine my final choice. There are many, many other factors I take into consideration, and this pre-employment test is only one. 


If anyone believes they should be hired based on their dazzling personality alone, this is unfair to the many coders who have taken the time to learn their craft well enough to successfully complete an employment test. We all know that everyone's on their best behavior during an interview, and this subjective view of the new candidate is just not enough for me. I need some objectivity: hence the test scores, to help me in part to make my final decision. Usually if the answers are in the ballpark, I score them as being 'correct', but if you coded a laparascopic procedure as open....well, that would not be a good sign. A job interview is no place for a rebuttal and I certainly don't want to get involved in a shoving match with a potential candidate. What would that say about you to a new manager? And if you mistrust the employment exam enought to want to fuss about it, or call it a waste of time, then the manager is not going to want you to work for them. 

In all sincerity, the manager may have had another good reason why you were not hired. It's usually about three things: *Will you be a good fit? Are you a reliable worker? Do you know what you're doing? *Those excuses such as "You don't have the right credentials", or "The position is filled" could mean one or more of the above, or simply that someone else was more desirable than you. Managers have to find the very best candidate...not one that we can sort of work around. 

I suggest you contact the interviewing manager and ask him/her what you might have been able to do differently in your interview to have been hired. Be prepared for the answer, but this information might be extremely helpful to you for your next interview.


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## sprkysgirl

I should have clarified that I was talking about doing the test remotely, so they do not observe anything but the test score? And I have also taken tests while at the interview and they usually stick you in a room and they are no where around to do any observing.


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## kevbshields

Most of these "exams" are utter uselessness.  Sorry, not stepping on toes, just expressing the other side.

I've been a hiring manager, give me a half hour with a candidate, and I'll tell you what he or she knows.  I've only been wrong once.  As for how any candidate will work out (habits or good "fits"), you cannot predict that with a coding assessment, sorry.  Social science literature handily disagrees with you there.  I'm pretty sure I could find academic articles to support my stance.

Most importantly, when the employer cannot explain the areas where you fell out, that is usually a sign a candidate shouldn't go to work for it.  If an employer cannot discuss a disputed case in a logical, non-threatening, non-defensive way (with prospective or rejected candidates), then the manager is either a.) fearful of confict, b.) insecure of personal aptitude, or c.) ineffective at his or her job.


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## MnTwins29

Question to Debra and Pam:  when you create the tests for coding candidates, do you use cases that would be specific to the job the candidate is applying or do you use any cases to gague overall knowlege?   When I was in a position where I did hiring, I did use tests but created several that were tailored to specific positions - if an outpatient coder, I had one with same day surgery, ER, etc.   If inpatient, only inpatient.  If radiology, only radiology reports - and so on.

I had a horror story a few years ago when I applied at a prestigious NYC hospital for an outpatient coding position.   I had a test with only three cases - inpatient chemo to a patient with cancer in several organs, a liver transplant patient and a heart transplant patient.   Yup, I am sure they did all of those procedures as outpatient services.   How the heck did testing me on those types of cases determine my fitness to code radiology and ED services?   And no, no one sat in the room to observe how I worked.   They just gave me the charts, said I had two hours and good luck. 

Also it isn't possible to always sit with a candidate to observe them the entire time.   Even without observing or even giving a "pass/fail" score, I didn't have troubles with picking out the right candidates.


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## bridgettemartin

*Remote coding assessment exams*

I took several assessment exams for remote coding positions.  
One very well known and respected remote coding company sent me an exam that was barely legible and 7 years old.  They had scanned an extremely poor copy that was printed crooked on the page.  I couldn't even make out 3 or 4 of the questions because they fell off the page.  Some of the codes were no longer valid codes (needed a 5th digit, etc).  Three of the questions had no correct answer.  I could go on and on.  Another remote employer advertised for an oupt GI coder.  I took the exam and passed.  During my phone interview I was told I wouldn't be considered because I didn't have Cardiology coding experience.  Yet another remote employer sent me an exam that took 2 hours to complete.  I completed it the day they emailed it to me.  The next day they contacted me to let me know I passed and because I passed they would hold my application on file for when they had openings.  Yes...they had no current openings when they advertised.


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## sprkysgirl

I love you Kevin and my thoughts exactly, I received and email today for another employer looking to hire a E/M coder and they wanted me to take the attached assessment test and send it back. I told them that I no longer take assessment tests and wished them luck on finding the right candidate for the job and that if my years of experience, credentials and professional references that I can send were not enough then I do not want to work for them. I am taking a stand and hope all other coders do to! Again thanks for your wisdom on this subject! They didn't even take the time to set up an interview first just take this test and nothing pertaining to we would like to set up an interview. Now how can you justify that? I am just not putting up with it anymore, employers need to relearn manners pertaining to employees and employees need to stick up for themselves because without us they will end up jobless themselves. So we need each other and respect goes a long ways! So I demand respect as I worked hard to get certified and have paid my dues in experience and if that isn't enough then move along nothing to see here!


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## Pam Brooks

MnTwins29 said:


> Question to Debra and Pam: when you create the tests for coding candidates, do you use cases that would be specific to the job the candidate is applying or do you use any cases to gague overall knowlege? When I was in a position where I did hiring, I did use tests but created several that were tailored to specific positions - if an outpatient coder, I had one with same day surgery, ER, etc. If inpatient, only inpatient. If radiology, only radiology reports - and so on.
> 
> I had a horror story a few years ago when I applied at a prestigious NYC hospital for an outpatient coding position. I had a test with only three cases - inpatient chemo to a patient with cancer in several organs, a liver transplant patient and a heart transplant patient. Yup, I am sure they did all of those procedures as outpatient services. How the heck did testing me on those types of cases determine my fitness to code radiology and ED services? And no, no one sat in the room to observe how I worked. They just gave me the charts, said I had two hours and good luck.
> 
> Also it isn't possible to always sit with a candidate to observe them the entire time. Even without observing or even giving a "pass/fail" score, I didn't have troubles with picking out the right candidates.


 
I always use examples from our current caseload, and only those cases that represent the kind of work the coder is going to be doing. So if I'm hiring an E&M auditor, I assemble a variety of E&M cases, consults, new/established, in/outpatient visits, from actual dicatated notes as well as our EHR. These examples are current, legible and complete. I don't see the point in testing on something that isn't part of our usual workflow. I don't consider my tests to be invalid if they are gauging the expertise of the candidates, but again, they are not the only tool I use. And it certainly takes me more than 1/2 hour to figure out whether someone is going to work out for me and the rest of my team, because I hire people with the understanding that I'm making a long-term committement. I make it my business to have them test within my line of vision, because I want to observe their demeanor throughout the testing. We employ a hiring process here called "behavioral interviewing", which allows us to make hiring decisions based on candidate's past and current behavioral responses. Although I don't use that technique exclusively, it's a very big part of how I evaluate a potential candidate. A lot can be gleaned by observing and asking about behavior, as well as asking pointed questions about coding knowledge, goals, education, personality and ethics. 

I wouldn't ever send a test to a candidate prior to an interview, but I can see why remote companies would....if you get 2000 applicants for the same job, a pre-test can weed out those who are unfamiliar with coding altogether. I typically get 50 candidates for most of my job openings, but I choose to hold off on the exam until after the phone interview and after the first on-site interview. The process I've used has been quite successful.


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## mitchellde

I do as Pam, we seem to think alike on many things!  I make the test relevant to the position.  I am still very much in favor of pretests. I have taken several myself for remote positions.  Many time the choices were all out of date and no correct choice, I put the correct codes on as an additional answer and explained my reasoning.  If you wish to not apply for a job simple because they want to test your skills then go for it.  But as Pam pointed a resume does not speak the volumes you want it to.  You have no idea how many people will pad a resume thinking no one will check up on things.  And many do not.  I have asked questions directly from resumes and the applicant had no idea what I was talking about.  It costs way too much money and valuable time to trust that a person knows their stuff only to find out you have have to hold their hand and stand over their should the entire time.  
I encourage all employers to test their prospective employees.


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## jmcpolin

I agree I think a somewhat limited coding assessment needs to be done in order to guage where the coder is at experience wise.  But on the other hand I interviewed for a very large international company that wanted me to complete this extensive spreadsheet and just add related terms to certain procedures it would have taken me hours.  I told them I was not going to basically to this work for free.  Anyway I found out later they are a company who are trying to fine tune their natural language process and an do believe that what I would have done they would have possibly used in their research, glad I refused.


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## kevbshields

Obviously we all have different approaches.  Although we employed behavior-based interviews, there were far more telling signs on the applicants Resumes and packets . . . oh yes, for federal jobs you must complete a packet.  The packet told enough about a.) a candidate's verbal skills, b.) experiential level, and c.) ability to communicate HIM concepts.  This is a big part of passing the first of several hurdles.  You can lie on a single piece of paper, but to extrapolate that out to multiple avenues, unlikely.

The interviews are always telling for their own reasons.  People arrive late, people arrive different days than the interview is scheduled, candidates arrive fully unprepared.  Then, there are those 2 or 3 who radiate when they show up.  These people have been able to supply narratives of their work and history, plus habits; they also neatly completed all the parts and pieces of the required packet.  They just show up to the interview with a command of their trade.  I'm sorry, to even suggest an assessment to these people is an insult.  If I'm stuck between two, then I'll have my boss decide during a second interview.  This almost never happens.  Of the 30 applications typically received for a job like this, less than 5 are generally qualified, by credential(s) and professionalism alone.

I guess what might also contribute to this difference is that we expect we'll have to train anyone who walks through the door.  Whether they've had 20 years or 2 months of experience, the unlearning, re-socialization and widening of skills almost certainly takes the better part of a year.  For us, underneath it all, we have to almost fully re-educate anyway.  Therefore, that someone knows how to code for a family practice or outpatient surgeries is good.  That the candidate can learn and take scrutiny, that's probably more important.  In all the times I've begged the powers that be for a perfect candidate for a vacancy, I never got what I wanted.  In retrospect, that was good--because I got something I needed instead.


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## carjjen

*Applied with a recruiter for Navy coding position*

I applied thru Indeed to a recruiter for a Navy hospital coding job and received 13 pages to fill out, which I did. The 8-pg coding assessment test was completed and all were faxed back. The response I got was, can't hire an apprentice.  I said I was an apprentice in the application, I said I was an apprentice in my resume submission and took a lot of time to take their coding assessment test, only to have the application tossed back because I was an apprentice, they said nothing about how I did on the assessment.  I was very upset about having spent a lot of time completing everything they asked for, and faxing back 13 pages, only to discover they apparently didn't even look at my assessment, because their response was "would you be interested in taking our coding assessment so that we can assess your skill level at this time?"
Then I applied for health unit coordinator position at a hospital, got an interview a month after applying and now two months later have not heard anything back and have followed up four times with phone calls and have been completely ignored. The job is still listed and I was told there were 4 other applicants beside myself, but all of us are not competent enough to be a HUC? 
And then a part-time HIM job was advertised, but they are going to EHR/EMR in May, so why would I apply for that job, only to be laid off??? 
It seems to coders who are saying "keep at it" don't understand it is impossible to find a job today!  The more time that goes by between my certification and job applications must be a red flag, but I know for sure the apprentice designation has hurt my chances of employment and I have been a transcriptionist for decades!!!!  Also, the survey about whether to keep the apprentice designation was answered by a very small percentage of the total number of members, and that's what AAPC is sticking to!!!!


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## NMHall

I am an experienced physician compliance auditor who has recently been looking for full time remote work, so I have also been subject to taking these tests.  Interestingly enough, I took an E&M coding test for a position and I was told I did not pass.  When I asked to see the answers from the company, they told me they could not give me that information.  So I had 2 other auditors I know take the test and they came up with the same answers I did!  It's very frustrating with all the years of experience I have, as well as all of the certifications, that I am told I lack the qualifications (i.e., passing the test) for a job that I could run circles around.  It's times like this that I wish I had the financial ability to open my own consulting business.


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## daguilar@swgiassoc.com

OMG, doesn't your Certification count for anything?  You go spend 4+ hours on a 150 multiple choice test, the CPC test is random in their questions and not specific to any speciaity coding, the job you apply for is usually for a specialty, so why can't your certification suffice instead of taking another test ????


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## Hipoink

Seems to me that alot of these "open postions "are a way to collect names for a coding pool. The openings do not exist. Their software for applications and exams are outdated and smattered with errors. I've spent way too much time navigating through endless pages of required information only to find out that the openings do not exist or it's another ploy to join a social network. The job sites are roguish and impossible to manever. Their links are broken or require a different size text or format for your uploaded resume. I had one company inquire that I download windows 6 so that I may access their application format.  I just responded to them...no thanks. And yes we have all taken their tests and gotten the "you did not pass".  That's because we gave up-to-date answers to out-of-date tests. Of course the answers will not match. A HR person wouldn't know the difference.  I only surmise that the process will continue as the field is now flooded with new job seekers. I just recently started to respond to such tire kickers as to whether they have a fulltime opening or are a contract company or building a coding pool. This really seems to irritate them, but they do respond either way. Of cousre this is done after they have sent me their "test" and prior to me spending one minute taking their "test". That's my FYI!!


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## Pam Brooks

There's a distinct and important difference between employment tests administered by hospitals or practices who need to hire coders with the appropriate level of skill and experience, and those remote companies that nobody's ever heard of who administer questionable pre-employment tests to acquire your personal information for their own purposes.  I happen to be employed by the former group.

A CPC certification means you have an overall understanding of coding, and although,  daguilar, it certainly does count for something, it is no substitute for experience and expertise when you are being hired to code for a specific specialty, a multispecialty group, or to work as a compliance auditor or documentation improvement specialist.    I am unwilling to risk my providers' integrity, my hosptial's compliance and my authority as a manager by bringing on staff who may have certification(s) in place, but can't code to save their lives.


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## jyotirvora

*Remote Test*

I once tested Remotely for a Job and they did not even get back with me if I passed or not. The test was ok but it would be good to know if I did pass or fail.

Thanks
Jyoti Vora CPC-A,CPMA


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## gord2110

I know I am late to this conversation, I just happen to come across this browsing on the forum, but I absolutely agree we should boycott these tests. So many wasted hours! I had the same thought, did I just code your IP, OP & ED cases when I'm only applying for a SNF Pro Fee position! Thank you for putting this out there. Nice to see I'm not the only one that feels that way!


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## ChrisZim

I've had a few that were so out of date the multi-choice answers didn't even include the correct choices for strokes - how long ago did those codes change?  That was a red-flag to me that that company doesn't have good quality control, and I wouldn't want to be part of it anyway!


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## ChrisZim

*100% agreed!*



Pam Brooks said:


> There's a distinct and important difference between employment tests administered by hospitals or practices who need to hire coders with the appropriate level of skill and experience, and those remote companies that nobody's ever heard of who administer questionable pre-employment tests to acquire your personal information for their own purposes.  I happen to be employed by the former group.
> 
> A CPC certification means you have an overall understanding of coding, and although,  daguilar, it certainly does count for something, it is no substitute for experience and expertise when you are being hired to code for a specific specialty, a multispecialty group, or to work as a compliance auditor or documentation improvement specialist.    I am unwilling to risk my providers' integrity, my hosptial's compliance and my authority as a manager by bringing on staff who may have certification(s) in place, but can't code to save their lives.



Pam, you are 100% correct!  Providers and facilities need to take responsiblity for the quality and accuracy of their coding and I would have no problem with them requesting testing.  IT positions and many others require testing as well.


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## ivorytofu@hotmail.com

*remote testing*

I have had the same issues with this remote testing. Sounds like several of us have applied with the same companies after reading the post. My latest test was from Bonnie and I have yet to hear back from her. This will be the 3rd time I have tested with her only to hear from her months later to update my resume and take a test. After this last on I started to wonder if I was taking the test for her to get a job since she fails to respond after the test are completed.  I spent 2 days on one remote test they sent me over 100 charts to code and then i was told i did not meet the qualifications, lol...I will never spend that much time on a test again.  Several of the post on this thread sounded just like some of the test I have taken. Very frustrating.


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## Ldwire

If you are applying for a coding job and you will be coding radiology. The test should be radiology. I took a coding test for a remote radiology position. the test was about outpatient codes.


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## GaPeach77

kevbshields said:


> Most of these "exams" are utter uselessness.  Sorry, not stepping on toes, just expressing the other side.
> 
> I've been a hiring manager, give me a half hour with a candidate, and I'll tell you what he or she knows.  I've only been wrong once.  As for how any candidate will work out (habits or good "fits"), you cannot predict that with a coding assessment, sorry.  Social science literature handily disagrees with you there.  I'm pretty sure I could find academic articles to support my stance.
> 
> Most importantly, when the employer cannot explain the areas where you fell out, that is usually a sign a candidate shouldn't go to work for it.  If an employer cannot discuss a disputed case in a logical, non-threatening, non-defensive way (with prospective or rejected candidates), then the manager is either a.) fearful of confict, b.) insecure of personal aptitude, or c.) ineffective at his or her job.



I agree with you 100%. When I was a coding manager I said the same thing.  A coding manager who knows how to code should not just depend on a test score.  If they have a good knowledge of coding they can decipher the potential to bring a coder up to par without having to depend on the test score.  I rather know how well your mainstream basic coding principles are, not some over the top cases that one has never coded  and never will again. Why some places insist on giving paper coding tests when 3M and other programs are there is beyond me.  Its so archaic. These days I rather know how well a person can work 3M and Encoder or how fast they can utilize resources to get the correct coding answer.  I would be more impressed with coders knowing the disease process or a coder with an anatomy and physciology college credit.  Also, what are you saying about your own coding credentials and its organization when you insist on retesting potential candidates?  I just dont get it. Also, the faciliators of alot of these exams get their questions from other exams, etc to the point that there are alot of tests going around the circle of coders with answers attached. The candidate that you hire based on their coding score just might be in the 'circle" and received the answers. Being alone for four hours to take a test, you can practically go to Kinkos, copy the test and come back before anyone knows your gone. There are too many coding tests answers going around to (especially remote) to gauge whether a person would be a good coder based on a test.  Smarten up people! The coding world has changed.


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## kevbshields

You are brave to discuss that.  In the consulting world, it used to be no big deal for people to ask if you had tested for a certain vendor or agency.  Then your answers would be solicited.  Once, someone even offered to pay to have me take it for them.  I've never discussed this and certainly didn't oblige any of the requests, but the point is that when you mention "circles" of testing, it is really going on.

I especially like when copyrighted material from AAPC or AHIMA is used without their permission on some of these assessments.  It just makes you wonder which party is being more unethical, the test takers or the test makers . . .


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## chimera07

Just wanted to comment on the employer observing you while your testing.  I have been in the testing rooms and have noticed that there is a mirror or a window that looks out to the offices (conference room).  They can see what you are doing and that is one way or they will have 2 to 4 people in the same room testing just to see if anyone speaks outloud.  I know this is not fair but it has happened to me on several occassions when I was looking for work.  I am glad I don't have to do that anymore for now.  But just be sure that these days it is all about the accuracy of coding and to see if you will fit on the TEAM.


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## jepcpc

I completely agree, however, I understand that the company needs to know that the coder knows her/his job.  Setting the bar high makes sure they have a coder that has learned and can apply their knowledge appropriately.  With that being said, is there any kind of refresher webinar for CPC?  I am very anxious about taking a pre-employment coding test with great fear that I might have forgotten a detail or two.  I would like to have things fresh in my head so there is no second guessing.


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## mlbaker1974

*pre-employment coding test*

I don't mind taking the tests. What I would like is the opportunity to know which questions I answered correctly. Also I would like to know if anyone has resources that they used after either failing or just not feeling like you performed well. How do you prepare for pre-employment tests? I would like to know where I need to improve but without knowing where I messed up it makes it tough. I am actually considering ordering the prep tests from AAPC in order to try and prepare.


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## camillecoder@hotmail.com

*Employee Assessment Tests - Pro*

I agree with Debra and Pam.  Coding tests are only one component of the hiring assessment.  I send three op notes home with the candidate for procedures that we do frequently.  Just because someone is certified doesn’t mean he or she can abstract information from a chart note.  I want to know whether someone can understand basic/general medical terminology, knows how to use a CPT and ICD book (yes, seriously), can interpret medical terminology into coding language, is thorough, is resourceful, will ask questions and/or admit that they don’t know, and can “connect the dots.”  Two recent candidates I interviewed did not have cardiology (this is a cardiology practice) experience and did not get all of the CPT codes correct.  However, that did not eliminate them from being considered and one of them was offered a position.  

You might consider their test to be a test of your own.  Do you want to work for someone who is careless about his or her assessment or is too busy or too inconsiderate to get back to you?  It’s even possible that the “bad” tests are tests of their own.  Will the candidate speak up if something is outdated or incorrect?  Will the candidate speak up if the test seems excessive?  How will the candidate approach an issue like this?  

I do agree that feedback is important.  It’s one of the criticisms I have with the AAPC exams.  Sure, I passed but what did I get wrong?  I want to know so I can learn to do it right.


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