Trilogy Federal is seeking a highly skilled and motivated Business Analyst – ClaimsXM/ECAMS Support to join our team. The ideal candidate will possess experience in claims data analysis, business process analysis, and process improvement. This role requires strong analytical and stakeholder engagement skills to support requirements development, data-driven decision-making, and optimization of claims processes. Knowledge of VA claims transactions (837 and 835) is required.
Demonstrated experience with Acentra (formerly CNSI) Electronic Claims Adjudication Management System (eCAMS) Electronic Healthcare Claims Edition/Engine (HCE) and Pegasystems (PEGA) Smart Claims is desired, along with familiarity with other legacy platforms and solutions supporting the Veterans Family Member Program (VFMP) claims processing.
This position may require occasional travel in support of client needs and expectations.
Primary Responsibilities
- Collect the requirements for automating the manual entry for claims
- Identify opportunities for process improvements and contribute to developing business requirements to enhance system and overall program performance.
- Reduce the errors/rejection of claims processing
- Lead multi-stakeholder workshops and presentations, clearly articulating integration priorities and constraints to both executive and technical audiences.
Minimum Requirements:
- Bachelor’s degree required.
- Veteran Affairs Claims system/processing experience
- Minimum 4 years total experience.
- Agility and ability to change course based on shifting plans, priorities, and timelines.
- Strong analytical, problem-solving, facilitation, and communication skills, including written, verbal, and interpersonal.
- Excellent organizational skills and strong attention to detail.
- Ability to prioritize and manage multiple tasks concurrently.
- Ability to thrive in a dynamic environment focused on learning, opportunities for impact, and collaboration with colleagues.
- Proficient in the following MS Office Applications: Word, Excel, PowerPoint.
- The ability to obtain Public Trust Clearance.
Preferred Qualifications:
- Prior experience working in a healthcare organization (e.g., hospital, health system, health insurance company, military health etc.).
Benefits (including but not limited to):
- Health, dental, and vision plans
- Optional FSA
- Paid parental leave
- Safe Harbor 401(k) with employer contributions 100% vested from day 1
- Paid time off and 11 paid holidays
- No cost group term life/AD&D plan, and optional supplemental coverage
- Pet insurance
- Monthly phone and internet stipend
- Tuition and training reimbursement
Skills Required
- Bachelor's degree
- Minimum 4 years total experience
- Knowledge of VA claims transactions (837 and 835)
- Veteran Affairs claims system/processing experience
- Experience with requirements gathering and business process analysis for claims automation
- Strong analytical, problem-solving, facilitation, and communication skills
- Excellent organizational skills and strong attention to detail
- Ability to prioritize and manage multiple tasks concurrently and adapt to shifting priorities
- Proficient in MS Office (Word, Excel, PowerPoint)
- Ability to obtain Public Trust Clearance
- Demonstrated experience with Acentra (CNSI) eCAMS, HCE, Pegasystems (PEGA) Smart Claims or other legacy claims platforms
- Prior experience working in a healthcare organization (hospital, health system, insurer, military health)
What We Do
Founded in 2009 and headquartered in the Washington DC metro area, Trilogy Federal is a verified service-disabled, veteran-owned small business (SDVOSB) providing financial management and information technology consulting to the Federal government. Trilogy has an extensive and distinctive history helping Federal clients achieve their financial management goals. Our leadership team has over 60 years of combined experience supporting Federal financial management initiatives. Our professional staff specializes in federal financial management and maintains certifications in several relevant programs. Trilogy strives to provide its clients with a flexible and comprehensive approach to financial management with the ultimate goal of fiscal compliance and audit readiness. The Trilogy approach starts with assessing the financial management solution and determining its effectiveness in capturing functional business requirements and meeting agency reporting requirements. Since our inception, we have assisted our federal partners in migrating to new financial management systems or enhancing existing systems to meet new requirements. Ultimately, success lies in the data, where Trilogy utilizes industry leading Business Intelligence and Business Performance Management tools to assess the overall effectiveness of financial business operations and to produce timely, reliable and value-added financial reporting. We have a proven track record of successful implementations for agencies large and small.
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