Audience: Medical coders and those in the medical field looking to learn more about the claims process and QNXT software
Role: Instructional Design, eLearning Development, Visual Design, Storyboarding, Action Mapping, Prototyping
Tools Used: Rise 360, Articulate Storyline 360, Adobe Creative Cloud, Figma, Napkin AI, VEED AI
The Need
This course provides a comprehensive understanding of medical claims processing, highlighting its vital role in healthcare revenue. The main goal of the course is to identify and differentiate CMS-1450 and CMS-1500 forms, recognizing their essential sections. The course also covers information sources for both CMS forms and introduces the QNXT system, explaining its function and practical application in claims filing.
The Process
I collaborated with the SME—an experienced medical biller and coder who works at a local clinic in New Mexico—to meticulously outline the claims processing workflow and identify key challenges. This collaboration ensured that the course content directly addresses the practical needs and complexities of the medical claims environment.
Action Map & Interactive Prototype
Based on the insights from the SMEs, I developed a detailed action map to visually represent the entire claims processing journey, from initial patient encounter to claim resolution. This map served as the foundation for creating an interactive prototype. The prototype allowed for early testing and feedback on the course’s navigation, interactive elements, and overall user experience, ensuring a smooth and intuitive learning path.
Full Development
Following iterative feedback from the prototype phase, I fully developed the course content. This involved creating engaging multimedia elements, including animated scenarios demonstrating claims submission and interactive exercises. Aside from knowledge checks, guided tutorials— fully developed in storyline—are included in each module to facilitate skill-acquisition and meet objectives. Additionally, the course was built using Rise 360 and incorporates a blend of visual aids, practical examples, and knowledge checks to reinforce learning and prepare participants for real-world claims processing tasks
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