Healthcare claims move through multiple teams before they become a completed audit decision. Each team has its own workstream, review criteria, permissions, and reporting needs. Claim HUB was designed to bring that complexity into one clear, scalable workspace.
Designing a Scalable Claims Management Experience
Claim HUB — Bringing complex healthcare audit workflows into one connected workspace
Claim HUB is an enterprise claims management portal used to assign, review, track, update, and report on healthcare claims across multiple audit workstreams.
The challenge was not simply to make claims easier to view. The product had to support different teams with different goals while handling dense information, high-volume operations, financial recovery decisions, permissions, reporting, and a complete history of what happened to every claim.
I approached the product as a system rather than a collection of screens — designing the experience around the decisions users make, the information they need at each step, and the operational scale of the platform.
Claim HUB — The Operational Workspace
Understanding the Problem
Claim auditing is rarely a linear process. A claim may move between auditors, clinicians, administrators, and different workstreams depending on the type of review required.
Before Claim HUB, these workflows created several recurring problems: users had to work around rigid screens, administrators relied on manual assignment processes, reporting required extensive data handling, and reviewers had to navigate away from their working context to find supporting information.
The opportunity was to create a single platform that could remain simple for everyday users while still being powerful enough for enterprise teams.
Claims contain a large amount of operational, clinical, financial, and audit information.
• Reviewers needed the right information without being overwhelmed.
• Different workstreams required different fields and levels of detail.
• The interface needed to support both quick scanning and deep investigation.
Reviewers often had to move between lists, claim details, recovery calculations, comments, and supporting information.
• Every unnecessary page transition interrupted the review.
• The side panel became a key mechanism for preserving context.
• Bulk actions reduced repetitive work for administrators.
The platform needed to work across multiple teams and thousands of claims without forcing every user into the same workflow.
• Role-based permissions controlled access.
• Workstreams determined how claims were handled.
• Configurable tables and filters allowed teams to create views that matched their jobs.
Defining the Design Challenge
The design challenge became broader than building a claims table. We needed to create a flexible operating system for claims teams that would allow users to:
- Find and understand claims quickly.
- Review detailed information without losing context.
- Assign and update large groups of claims efficiently.
- Record recovery decisions and supporting comments.
- Customize tables, filters, and side-panel information.
- Maintain traceability through history and audit records.
Complexity should live in the system.
Not in the user's head!!
Research & Discovery
To understand the operational reality behind the screens, I collaborated with cross-functional stakeholders across the claims lifecycle.
Stakeholder conversations and workflow walkthroughs focused on:
- Auditors and clinicians reviewing claims
- Administrators assigning work
- Teams managing different workstreams
- Reporting users tracking completed work
- Users managing permissions and access
Rather than asking only what features users wanted, I focused on where decisions became difficult, where users repeated work, and where the existing workflow broke their concentration.
That led to a simple product principle: give users control over the information and actions that matter to their work.
Key Insights
The workflow revealed five principles that shaped the product.
- Context reduces cognitive load
- Reviewers should not have to leave a claim list every time they need more information.
- Different teams need different views
- A single fixed table creates unnecessary noise for specialized teams.
- High-volume work needs high-leverage actions
- Bulk assignment and bulk updates are essential, not secondary features.
- Every decision needs traceability
- Comments, history, status changes, and recovery decisions need to be easy to understand later.
- Flexibility must remain understandable
- Customization is valuable only when users can control it without becoming administrators of the system.
Design Decisions
Designing around real claim-review tasks rather than individual screens.
Decision 1
Instead of sending users to a separate detail page for every review, Claim HUB uses a detailed side panel.
• Users can inspect review status, auditor, financial information, findings, recovery amounts, and other claim details.
• The claim list remains visible in the background, preserving the user's place in the workflow.
• The approach supports fast scanning as well as deeper investigation.
Decision 2
Recovery amounts can come from multiple categories. A single input field could not represent the way auditors actually worked.
• Users can add multiple recovery categories.
• Each category has its own amount.
• A running total makes the financial outcome visible before saving.
• The interaction supports both an empty starting state and a completed recovery calculation.
Decision 3
Although claims can arrive from backend systems, operational teams still need a controlled way to add or correct claims manually.
• Individual entry supports one-off claim creation.
• Multiple rows allow users to prepare several claims in one session.
• Inline validation catches incorrect or duplicate combinations before submission.
Decision 4
For high-volume operations, administrators can use a standard Excel template to prepare claims and assignments outside the portal and upload them back into Claim HUB.
• Download a standard template.
• Enter the required claim and assignment details.
• Upload the completed file.
• Validate the changes before committing them.
This turns a potentially complex batch operation into a familiar spreadsheet-based workflow while keeping validation inside the product.
Decision 5
Different teams work with different data. Rather than forcing every user to consume the same dense interface, Claim HUB makes the experience configurable.
• Show or hide table columns.
• Reorder information through drag-and-drop.
• Configure review and report filters.
• Create a side-panel experience that exposes the information most relevant to the team.
Decision 6
Bulk actions can save time, but they also increase the impact of mistakes. The experience therefore separates selection, review of proposed changes, and confirmation.
• Users select multiple claims.
• The system summarizes the selected records.
• Users choose the new status or auditor and add an optional comment.
• A review step highlights potential conflicts before the update is confirmed.
Decision 7
Claims are not just records; they are decisions that may need to be understood later. Comments and history therefore became part of the workflow rather than an afterthought.
• Users can document the reasoning behind decisions.
• Previous comments and actions remain available for review.
• Status and assignment changes provide a clearer audit trail.
Decision 8
Permissions should reflect how work is actually organized. Claim HUB connects roles, restricted claim access, and workstreams so administrators can manage who can work on what.
• Assign roles such as Admin, Super Admin, and Auditor.
• Restrict access to claims where required.
• Assign users to relevant workstreams.
• Update access without requiring a technical administrator.
Reporting Without Losing Operational Context
Reporting is part of the claim lifecycle, not a separate activity. The reporting experience gives teams a structured way to search, filter, sort, and export claims that have been worked on across the organization.
The same principle of configurability carries through: teams can decide which report columns matter to them instead of receiving a fixed, overloaded export.
The System Behind the Experience
One of the most important parts of Claim HUB was the underlying design system. The product contains dense tables, forms, side panels, filters, status controls, confirmation states, and administrative workflows.
Reusable components and consistent interaction patterns made the experience easier to learn and gave engineering a scalable foundation for new workstreams and future features.
The goal was not simply visual consistency. It was behavioral consistency — users should know how a search, dropdown, validation message, bulk action, or confirmation works wherever they encounter it.
Impact
Because Claim HUB is an enterprise healthcare product, the most meaningful outcomes are operational rather than purely visual. The platform created a common workspace for teams that previously needed to coordinate across different processes.
- Centralized multiple claim-review workflows in one platform.
- Reduced repetitive work through bulk assignment and update flows.
- Improved review efficiency by keeping claim context available in the side panel.
- Gave teams control over the data they see through configurable tables and filters.
- Improved traceability with comments, decisions, status changes, and history.
- Created a scalable foundation for multiple workstreams and user roles.
Due to the confidential nature of the healthcare product and project, quantitative business metrics are not disclosed in this portfolio case study.
What This Project Taught Me
Claim HUB changed the way I think about enterprise healthcare products. The hardest part is rarely the amount of information alone. The real challenge is deciding what deserves attention, when it should appear, and how much control the user should have over it.
I learned that flexibility is a form of usability. A clinician, auditor, administrator, and reporting user may all work with the same claim, but they should not be forced through the same mental model.
The strongest outcome was not any single screen. It was creating a system that could absorb complexity while making the user's work feel more predictable, focused, and controllable.
