BMI

Tibco Cloud Configuration

Helping dev teams with data replication by providing a visual data management experience.

BMI - Claims Auditing

Overview

BMI provide insurance claims auditing service for organizations. Their clients are large scale organizations across US amounting to 500,000+ claims being audited annually by BMI's auditors.

BMI wants to pivot their business by rebuilding as a SaaS auditing platform while retaining a white glove experience for their clients. Over the course of our engagement I designed an ecosystem of 3 interconnected products for different phases of claim auditing. Here I will showcase few solutions we built.

My Role

I owned the end-to-end design of the platform along with building it's supporting design system.
I also created product prototypes and defined success metrics for the validation tests.

Duration

August 2021 - May 2022
(10 months)

Team

1 Product Designer (Me)
1 Product Manager

BMI
Director of Product
Lead Backend Developer
Frontend Developer
2 Internal Claim Auditors

Tools

Figma
Whimsical
Dovetail

The Users

Internal Auditors & Clients

With the new SaaS model, BMI's internal single persona of auditor was discussed and expanded to a cohort of user personas on their team and client's side.

Conversation scheduling with the most complex configuration possible

THE CHALLENGE

Multiple touchpoints, Single software

BMI created an internal tool used by their auditors, but the audit flow was fragmented with different users using different tools, causing redundant communication and important information being lost.

Difficult to filter & audit claims

Auditors complained that filtering to find suspicious cliams was tedious and often repetitive. Once found, all claim information was in long horizontal tables.

Lacking information about insurance members

Auditors wanted to see the context around a member to better understand their claim history to decide if one of their claims can be reported.

THE SOLUTION

Multi-user product ecosystem

We designed a Monitoring and Audit tool to better cater to the user's needs. These tools remove the need to other apps by incorporating vital features like building & collaborating on reports and sharing progress. It also allows BMI to market effectively to different segments of the domain in coming years.

Shareable filtered views

Auditors can now save their filter and search criteria into a 'Saved View'. This View can also be shared with other auditors working on different clients.

Insurance member details in context of the whole audit

Auditors and Third Party Auditors can now view member details. They can also look at their claims across different categories and use the 'Saved Views' feature to efficiently find claims.

Design System built for the product ecosystem

BMI is set up for success with a consistent and scalable design system, which includes common interaction patterns, design tokens and tone guidelines.

TESTING RESULTS

Internal validation tests showed approval by 6/6 participants

As BMI is gearing up to make this product a reality, we conducted validation tests with 4 internal auditors and 2 valued clients. They recommended feature tweaks and overall approve of the direction chosen for these product.

Due to restrictions I cant share design artefacts on the website. But, I would like to show them to you in person.

Other Design Case Studies

BMI Audit

Defined product ecosystem and built product designs for an enterprise insurance audit service company.

View Case Study