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Self-Funded Billing Modernization

Timeline

November 2024 - January 2025
(Releasing 2025)

Platform

Internal Product (SaaS)

Roles

UX Researcher

UI Designer

Collaborators

Senior UX Designer

End Users

Product Ower

Context

In late 2024, a senior UX designer and I were engaged to assess the usability of a newly developed claims billing system. This platform functions as a database for tracking and managing medical claims. Initially designed without UX input, the system faced strong user resistance during early testing. In response, we were brought in to evaluate the platform, identify usability issues, and provide recommendations to improve the user experience. Our goal was to align the system with the needs of the claims billing team and ensure a smoother, more efficient workflow.

Outcomes

Through user research, iterative design, and usability testing, we significantly improved user satisfaction. After implementing our recommendations and testing a functional prototype, the updated interface received an average user satisfaction score of 3.75/5, marking a notable improvement from previous feedback. Due to resource constraints, the project is currently paused but is expected to launch later this year as a SaaS product available to other enterprises.

Our UX Approach

Defining the Problem

Before initiating any design work, we aimed to understand the billing team’s specific pain points with the current platform. Rather than designing in vain, we conducted stakeholder interviews to gain insight into daily workflows, inefficiencies, and user frustrations.

Our Focus

1. Primary Navigation
2. Missing features from legacy system
3. Inconsistent page patterns (font sizes, layouts, interactions)

Key Findings

To uncover these findings, we conducted in-depth stakeholder interviews, shadowed users as they interacted with both systems, and analyzed common pain points from previous complaints. This research revealed some discerning factors about the team that we wanted to keep in mind moving forward:

Understanding our Users

In addition to identifying areas to improve, the stakeholder interviews allowed us to understand deeper insights into the team’s characteristics and frustrations with the new proposed system. I noted some characteristics for the average user, displaying expected behaviors in this manner:

Challenges

🔹 Many users are not technically savvy and struggled with interface changes.
🔹 Some terminology used in the platform did not align with industry billing standards.
🔹 Frequent system issues led to excessive support ticket submissions.

Goals and Needs

📌 An intuitive platform that is easy for new users to understand.
📌 Increased efficiency for all roles.
📌 Reduction in support tickets related to usability issues.
📌Modernized look and feel.

Review of Legacy and Proposed Systems

Analyzing both the legacy and proposed platforms allowed us to validate user concerns and identify critical areas for improvement. Some of the the issues we noted below:

Navigation

The legacy system had a navigation ribbon with multiple tabs differentiating functionalities. The new platform condensed navigation into two tabs, requiring users to rely on dropdown menus. This change caused confusion, as users had to relearn where to find essential functions.

Search Capabilities

In the legacy system, users could search claims with an ‘All’ filter, which retrieved all applicable claims in the system. While this violated accessibility and company compliance policies due to excessive load times, restricting searches to predefined filters in the new system frustrated users. We needed to create a compromise that allowed for broad searches while maintaining compliance.

Account Details Screen

Users spent the majority of their time on the Group/Product Information  screen. In the proposed redesign, key workflows were hidden behind an expandable side navigation panel, leading to confusion. The layout needed to be revised to provide better context and visibility.

Workflows

Claim billing workflows involve complex processes. The proposed design attempted to simplify these by using a stepper UI, but since steps were not always sequentially dependent, this approach disrupted user expectations. We needed to rethink the UI to support flexible workflows.

Inconsistent UI

A lack of consistency across screens increased cognitive load and reduced usability. Notable inconsistencies included:

- Undefined typography hierarchy.
- Unintuitive labels for buttons and fields.
- Missing helper text for key workflows.
- Inconsistent date formats.
- Missing scrollbars in modals.
- Poor adherence to proximity principles, causing key actions to feel disconnected from their context.

Site Mapping & Wireframing

After conducting research, we developed a site map to create a clear, intuitive navigation structure. This helped streamline user pathways, making information more accessible and reducing complexity.

Building on this, we designed wireframes for search and group/product information screens, focusing on layout, hierarchy, and user flow. We aimed to minimize cognitive load by structuring content intuitively, improving findability while ensuring clarity, consistency, and accessibility.

💡 Pivot Point: After providing our research findings to upper management, we were instructed to build high fidelity mockups and present them to the claims billing team. This meant we needed to validate our design through user testing and create a functional prototype.

Iterative Prototyping & Design Thinking

Using a design thinking approach, we developed low, mid, and high-fidelity mockups, incorporating user feedback at each stage. Collaborative Figma sessions helped validate our design decisions.

Initial Approach

With the navigation already established in the wireframes, I focused heavily on consistency. I employed our design system to resolve typography issues and standardize components such as buttons and text fields. I knew this would address most inconsistencies, enhancing the platform’s usability and learnability.

After reviewing my initial mockup, the senior designer noted that the colors would likely need adjusted for accessibility. I was still dissatisfied with the information hierarchy of the Group/Product Information screen, so I knew further iteration was necessary before user testing.

Further Refinement

As I continued to iterate on the design, I made several changes. First, I addressed color accessibility issues by using a contrast checker, which helped me identify problematic color combinations and make necessary adjustments. Next, I changed the static data container's layout from vertical to horizontal. This freed up significant space, allowing me to move elements upward and reduce scrolling—another pain point the billing team had reported. I also incorporated the bill account dropdown into the data container, as it was directly related to all the information within it. These changes, along with others, significantly improved screen clarity and helped the design take shape.

After collaborating again with the senior UX designer, we agreed that the mockups were progressing well. I still needed to refine the active states for the side navigation and toggle button as well as adjust the colors of the search results table to align with the platform's color palette.

User Testing & Feedback Synthesis

Usability tests with real users provided qualitative feedback and key performance indicators such as task completion rates and error occurrences. Major insights included:

Resolution

✅ Removed the advanced search function to prevent confusion
✅  Adjusted search so users can filter their results in the table instead of their search parameters
✅ Bill account status will be set to 'All' by default but certain search fields will require a 5-character minimum in order to meet WCAG and SLAs
✅ Reduced column size and added collapsible side navigation for additional space.
✅ Adjusted layout to a horizontal format for better accessibility.

Challenges & Pivot Points

Pain Point: Initial resistance from end users due to previous negative experiences with the new platform.
‍Solution: Conducted empathy-driven research (stakeholder interviews and audits of old and new platforms) to involve users in the design process and validate improvements.
‍
‍Pain Point: Limited development resources delayed implementation.  
‍Solution: Prioritized critical fixes and designed scalable solutions that could be implemented iteratively.

Lessons Learned & Next Steps

User Involvement is Key

Engaging users early ensured the redesigned workflows were intuitive and reduced resistance.

Data-Driven Design Works

Measuring KPIs like task efficiency and satisfaction scores validated UX decisions.

Balancing Usability and Compliance

Meeting accessibility and policy requirements while preserving workflow efficiency was a significant challenge that required creative problem-solving.

Next Steps

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