CCO Complex Claims Processing —HealthRules® - eLearning Curriculum
About the Project
Self-paced learning built with HealthRules Manager and Designer, Camtasia, Articulate Storyline & Cornerstone LMS
Overview
This eLearning collection was designed to convert complex claims workflows into scalable, self-paced modules. Using Camtasia and Articulate Storyline, I produced a full suite of interactive learning experiences covering Coordination of Benefits, Diagnosis Related Group, Indian Health Service, Home Health Inpatient Claims, Long Term Care, Anesthesia, High Dollar Review, Individual and Family Plan Mayo Clinic Processing, and more.
THE CHALLENGE
CCO Claims Operations needed a scalable and consistent way to train staff on complex claims workflows across multiple specialties, including COB, DRG, PCA, LTC, IHS, historical claims, pricing exceptions, and HealthRules Manager & Designer processing logic. Traditional live training required heavy Learning and Development Trainers “SME” involvement, created inconsistencies between classes, and slowed down upskilling.
The challenge was to build a self-paced eLearning solution that:
Translated complex, multi-system workflows into clear, step-by-step instruction
Included real HealthRules Manager & Designer system demos
Provided consistent, repeatable training for cross-training
Integrated job aids, triggers, and workflow logic
Tracked completions, accuracy, and quiz scores in Cornerstone LMS
Reduced operational risk caused by inconsistent claims processing
Scaled to support large training cohorts without SME burnout
This required converting raw system knowledge, demonstrations, job aids, and SME expertise into a structured, interactive, and production-ready digital curriculum.
My Role
Instructional Design & eLearning Production
Designed and built modules end-to-end
Scripted, storyboarded, designed, and produced content
Multimedia Video Editing
Camtasia screen recordings
Zooms, highlights, callouts
Clean narration flow
Storyline Development
Interactive demos
Click-through simulations
Embedded quizzes
Course logic & triggers
LMS & SCORM Management
SCORM export
Upload + test in Cornerstone Pilot
Quiz scoring setup
Reporting validation
Collaboration
Worked with 3 L&D trainers
Integrated job aids, triggers, and workflows
Reviewed and validated accuracy with Claims Ops + Configuration
eLearning Course Library
✔ Coordination of Benefits (3 modules)
✔ Community Paramedics
✔ Clinical Trials
✔ PCA Manual Review
✔ IHS Claims on Review
✔ Historical Claims Triggers
✔ DRG & Per Diem Pricing
✔ IFP Mayo Referral
✔ Modifier GA Review
✔ Payments & Remits
✔ HRP Upgrade Town Hall
✔ Anesthesia
✔ High Dollar
✔ Historical Line Crosses Date Range
✔ LTC Manual Pricing
✔ Unauthorized Provider Services
✔ HRP Promote
✔ Minnesota Medicaid APG-DRG Calculation
Design Approach
Camtasia Demo Recordings
Clean, precise system walkthroughs with highlights and instruction.
Articulate Storyline Interactive Learning
Simulations, branching, knowledge checks, and quizzes.
Integrated Learning Assets
Job aids, triggers, HRP workflows, and reference guides built in.
SCORM + LMS Reporting
Published directly to Cornerstone for tracking and completion accuracy.
Results
This eLearning suite became the primary training resource for cross-training across CCO department. It improved learner confidence, reduced SME load, increased accuracy, and supported long-term scalability for complex claims processing.