VA Claims Support

Trilogy Federal drives innovative solutions for complex business challenges across financial management, healthcare, and government industries. Our collaborative, client-first service approach, combined with our commitment to the rapid implementation of pragmatic solutions, has earned Trilogy an unparalleled reputation for delivering transformative results.

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

Trilogy Federal is an Equal Employment Opportunity employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.

Originally posted on Himalayas