Insurance Claims Processing (Enterprise)

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Background: Our client employed a central billing office to manage the insurance claims processing for a 200+ network of nationwide clinics. The data on the insurance claims were created from doctors’ visits, then reviewed, edited and sent by the central office to 700+ insurance companies. The existing system used by those submitting claims (“billers”) was not integrated with the system used in the clinics. This separation caused personal conflicts and distrust between the two types of users. The client suffered financially for this.

Design: The new system design allows the billing user to (1) quickly identify the most pressing claims to work (2) search for a specific claim, and (3) access all the functionality they need for troubleshooting a wide range of Payer requirements.

The client now clears 94% of their insurance claims the first time.

“Not only did her user-interface designs solve the problems that the client had expressed, but they anticipated and solved problems that no-one else had expected.” – Matt Chisholm, Former Co-Worker (Software Developer)

What I Did

  • UX / UI Design
  • Business Analysis
  • Information Architecture
  • User Research
  • Client & Accoun