Senior Operational Specialist (Escalations)

Job Description

NYU Langone Health is a fully integrated health system that consistently achieves the best patient outcomes through a rigorous focus on quality that has resulted in some of the lowest mortality rates in the nation. Vizient Inc. has ranked NYU Langone the No. 1 comprehensive academic medical center in the country for three years in a row, and U.S. News & World Report recently placed nine of its clinical specialties among the top five in the nation. NYU Langone offers a comprehensive range of medical services with one high standard of care across 6 inpatient locations, its Perlmutter Cancer Center, and over 320 outpatient locations in the New York area and Florida. With $14.2 billion in revenue this year, the system also includes two tuition-free medical schools, in Manhattan and on Long Island, and a vast research enterprise with over $1 billion in active awards from the National Institutes of Health.


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Position Summary:
We have an exciting opportunity to join our team as a Senior Operational Specialist.


In this role, the successful candidate reporting to the Manager, Revenue Cycle Operations, the Senior Operations Specialist is the primary owner of complex hospital A/R accounts and escalations. This role is responsible for independently investigating, resolving, and closing high-risk, high-dollar, and high-visibility A/R issues that cannot be resolved through standard workflows. The Senior Operations Specialist serves as the escalation point for operationally complex billing scenarios, payer disputes, system defects, and workflow breakdowns. In resolving these issues, the role identifies systemic gaps and drives targeted process improvements to prevent recurrence.

Job Responsibilities:

Ownership of Complex Accounts & Escalations

• Own the end-to-end resolution of complex, escalated hospital A/R accounts, including high-dollar balances, payer disputes, systemic billing defects, and regulatory-sensitive scenarios
• Serve as the operational escalation point when standard follow-up, billing, or denial workflows fail to resolve issues
• Conduct deep-dive account analysis across billing history, payer correspondence, system configuration, and contractual requirements
• Coordinate directly with billing, follow-up, IT, compliance, contracting, and payer representatives to drive resolution
• Validate final outcomes (payment, adjustment, correction, or appeal resolution) prior to closure

Advanced Issue Investigation & Root Cause Analysis

• Identify root causes of escalations related to workflow gaps, system behavior, incorrect configuration, or payer interpretation
• Distinguish between account-specific issues and systemic failures requiring broader intervention
• Document findings clearly and translate complex issues into actionable operational fixes

Targeted Process Improvement

• Drive process changes directly tied to recurring escalation themes (e.g., billing errors, payer rejections, handoff failures)
• Design and implement corrective workflows that reduce future escalations and manual rework
• Partner with the Manager to align fixes with operational priorities and risk tolerance

Operational Guidance & Knowledge Capture

• Create and maintain escalation-specific workflows, job aids, and reference materials based on resolved cases
• Ensure guidance reflects real-world system behavior and payer requirements
• Update workflows in response to Epic changes, payer policy updates, or regulatory impacts affecting hospital A/R

Tracking, Reporting & Communication

• Maintain accurate tracking of escalated accounts, resolution status, root causes, and outcomes
• Provide concise, actionable updates to leadership on escalation trends and risk areas
• Escalate unresolved barriers with recommended paths forward, not open-ended issues
• Performs other duties as assigned

Personal Characteristics

• Clear, confident communicator able to explain complex billing, payer, and system issues to both operational teams and leadership
• Highly detail-oriented with the ability to synthesize large volumes of account, system, and payer data into clear conclusions
• Proven ability to manage multiple complex escalations simultaneously while maintaining accountability for outcomes
• Strong critical-thinking and judgment skills, with the ability to make sound decisions in ambiguous or high-pressure situations
• Ability to adapt workflows and problem-solve in real time based on operational realities and end-user constraints
• Builds effective working relationships across operational, technical, and leadership teams to drive resolution
• Demonstrates ownership, professionalism, and persistence when working through challenging or high-impact issues

Patient Experience and Access

• Supports a consistent and respectful patient experience by applying the CARES principles in all interactions related to complex or escalated billing issues
• Communicates clearly and professionally with patients and internal partners regarding billing issues, next steps, and resolution timelines, ensuring transparency and follow-through
• Serves as a key escalation resource for patient billing concerns requiring advanced investigation, judgment, or cross-functional coordination
• Applies the LEARN model when supporting service recovery in sensitive or high-impact billing situations, escalating to leadership when issues present elevated risk or reputational impact
• Identifies and shares trends observed through escalated cases that may negatively impact patient experience or access, and recommends targeted improvements

Minimum Qualifications

Bachelor's Degree with a minimum of 2-4 years of relevant work experience or equivalent combination or training and relevant work experience. Candidate must provide an example of a process document he/she has created.


Qualified candidates must be able to effectively communicate with all levels of the organization.

NYU Langone Health provides its staff with far more than just a place to work. Rather, we are an institution you can be proud of, an institution where you'll feel good about devoting your time and your talents.

At NYU Langone Health, we are committed to supporting our workforce and their loved ones with a comprehensive benefits and wellness package. Our offerings provide a robust support system for any stage of life, whether it's developing your career, starting a family, or saving for retirement. The support employees receive goes beyond a standard benefit offering, where employees have access to financial security benefits, a generous time-off program and employee resources groups for peer support. Additionally, all employees have access to our holistic employee wellness program, which focuses on seven key areas of well-being: physical, mental, nutritional, sleep, social, financial, and preventive care. The benefits and wellness package is designed to allow you to focus on what truly matters. Join us and experience the extensive resources and services designed to enhance your overall quality of life for you and your family.


NYU Langone Health is an equal opportunity employer and committed to inclusion in all aspects of recruiting and employment. All qualified individuals are encouraged to apply and will receive consideration. We require applications to be completed online.

View Know Your Rights: Workplace discrimination is illegal.

NYU Langone Health provides a salary range to comply with the New York state Law on Salary Transparency in Job Advertisements. The salary range for the role is $75000-$105000 Annually. Actual salaries depend on a variety of factors, including experience, specialty, education, and hospital need. The salary range or contractual rate listed does not include bonuses/incentive, differential pay or other forms of compensation or benefits.

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Salaries shown on independent jobs related websites reflect market averages and do not represent information obtained directly from NYU Langone. We invite and encourage each candidate to discuss salary/hourly specifics during the application and hiring process.