Job Summary This role focuses on identifying, preventing, and reducing payor denials through data-driven revenue cycle and operational optimization for BSWH. The position partners with revenue cycle departments, HIM, Central Business Services, clinical teams, and IT to analyze denial trends, redesign workflows, and implement proactive controls that ensure accurate charge capture, documentation, and payor compliance.
The role leverages analytics, process redesign, and education to prevent denials upstream, improve efficiency, and drive stronger reimbursement outcomes across the health system.
This is an onsite position in Plano, Texas.
Essential Functions of the Role
Analyze payor denial trends and root causes to identify systemic issues across front-end, mid-cycle, and back-end revenue cycle functions.
Design and implement workflow improvements to prevent denials related to registration accuracy, prior authorization, medical necessity, coding, documentation, and charge capture.
Assist revenue cycle departments in data-driven workflow redesign and performance improvement initiatives.
Proactively identify revenue cycle inefficiencies, research data, and develop actionable solution alternatives.
Implement revenue cycle improvement solutions across BSWH departments and facilities.
Monitor revenue cycle performance using existing tools and metrics; develop new KPIs as payor requirements evolve.
Partner with Access Services, HIM, clinical departments, and Central Business Services to standardize denial prevention best practices.
Coordinate revenue cycle activities, including charge capture and workflow optimization.
Lead and support denial prevention education and training initiatives focused on payor requirements, documentation standards, and error prevention.
Facilitate communication and coordination between BSWH corporate teams and facility leadership to ensure consistent execution of initiatives.
Assess revenue cycle IT system capabilities and support enhancements that automate edits, validations, and compliance checks.
Examine operational trends and implement process redesign solutions that drive measurable financial impact.
Support project management for denial prevention initiatives, ensuring timely execution and sustainable results.
Key Success Factors
Strong project management experience with the ability to lead cross-functional initiatives.
Exceptional communication, analytical, organizational, and implementation skills.
Deep knowledge of revenue cycle operations, including denial prevention strategies.
Experience working with data, analytics, and performance metrics.
Healthcare consulting experience preferred.
About Us
Here at Baylor Scott & White Health we promote the well-being of all individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well.
Our Core Values are:
We serve faithfully by doing what's right with a joyful heart.
We never settle by constantly striving for better.
We are in it together by supporting one another and those we serve.
We make an impact by taking initiative and delivering exceptional experience.
Benefits
Our benefits are designed to help you live well no matter where you are on your journey. For full details on coverage and eligibility, visit the Baylor Scott & White Benefits Hub to explore our offerings, which may include:
Immediate eligibility for health and welfare benefits
401(k) savings plan with dollar-for-dollar match up to 5%
Tuition Reimbursement
PTO accrual beginning Day 1
Note: Benefits may vary based upon position type and/or level.
Belonging Statement
We believe that all people should feel welcomed, valued and supported.
QUALIFICATIONS
EDUCATION - Bachelor's or 4 years of work experience above the minimum qualification
Baylor Scott & White Health (BSWH) is the largest not-for-profit health care system in Texas and one of the largest in the United States. With a commitment to and a track record of innovation, collaboration, integrity and compassion for the patient, BSWH stands to be one of the nation’s exemplary health care organizations. Our mission is to serve all people by providing personalized health and wellness through exemplary care, education and research as a Christian ministry of healing. Joining our team is not just accepting a job, it’s accepting a calling!