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.

Job Summary

The Director, Underpayments is responsible for providing strategic leadership and operational oversight for the underpayment identification, recovery and prevention for Baylor Scott and White Health (BSWH). The Director, Underpayments will oversee the underpayment teams responsible for payment variance follow-up, recovery and contract compliance escalation activities. This role will be responsible for establishing standardized workflows, governance and payer escalation strategies to address increasing payment variance volume and complexity driven by evolving payer behaviors. Will lead external vendor resources supporting payment recovery efforts. Identifies, analyzes and reports on significant underpayment trends and patterns to key stakeholders. Collaborates with Revenue Cycle, Finance, Managed Care and other BSWH departments to align underpayment recovery efforts with broader operational priorities, accelerate cash recovery, improve financial performance and reduce recurring underpayment risk.

Essential Functions of the Role

·         Lead the enterprise underpayments strategy, including identification, prioritization, recovery, and prevention

·         Establish standardized underpayment workflows, policies, governance and performance metrics, including strengthened oversight for out-of-network payment disputes.

·         Direct daily operations of payment recovery efforts, including the development and implementation of payer-specific playbooks and escalation frameworks

·         Develop key operational and financial reports and establish key metrics essential for monitoring daily operations.

·         Use data and root-cause analysis to identify systemic issues and prioritize high-value recovery opportunities

·         Provide executive-level reporting for underpayment volumes, recovery rates, aging and cash impact

·         Serve as liaison to external vendors supporting recovery efforts

·         Engage with Managed Care and Contract Enforcement to escalate and resolve recurring underpayment drivers and enforce contractual compliance

·         Partner with Managed care and Contract Enforcement to align underpayment trends with contract language, negotiation strategies and payer performance management

Collaborate with Centralized Business Services (CBS), Revenue Cycle and other BSWH departments to address upstream drivers of underpayments

Key Success Factors

·         Bachelor?s degree in healthcare administration or related field. Master?s degree preferred

·         5+ years of experience in healthcare revenue cycle

·         3+ years of experience in a leadership role

·         3+ years Epic experience preferred

·         Proven ability to lead cross-functional teams in a complex healthcare environment

·         Strong knowledge of payer contracts, authorization requirements, claims adjudication and appeals processes

·         Proven ability to engage and influence payer and internal executive stakeholders

·         Experience collaborating across multiple departments and clinical disciplines within a large, complex healthcare organization preferred

·         Excellent presentation skills and ability to create executive-level presentations and deliverables

·         Ability to manage multiple priorities and drive performance improvement initiatives

Strong problem-solving and critical thinking skills

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
• EXPERIENCE - 3 Years of Experience

About Baylor Scott & White Health

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!

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