Senior Operational Specialist

About the Role

NYU Langone Health is a fully integrated health system recognized for achieving the best patient outcomes through a rigorous focus on quality, with 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 consecutive years, and U.S. News & World Report has placed nine of its clinical specialties among the top five nationally.

We are seeking a Senior Operational Specialist to join our Revenue Cycle Operations team. This role is the primary owner of complex hospital accounts receivable (A/R) and escalations, responsible for independently investigating, resolving, and closing high-risk, high-dollar, and high-visibility A/R issues that cannot be addressed through standard workflows. The Senior Operations Specialist serves as the escalation point for operationally complex billing scenarios, payer disputes, system defects, and workflow breakdowns, while driving targeted process improvements to prevent recurrence.

Responsibilities

• 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.
• 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.
• 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.
• 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.
• 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.
• Support a consistent and respectful patient experience by applying the CARES principles in all interactions related to complex or escalated billing issues.
• Communicate clearly and professionally with patients and internal partners regarding billing issues, next steps, and resolution timelines, ensuring transparency and follow-through.
• Serve as a key escalation resource for patient billing concerns requiring advanced investigation, judgment, or cross-functional coordination.
• Apply 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.
• Identify and share trends observed through escalated cases that may negatively impact patient experience or access, and recommend targeted improvements.
• Perform other duties as assigned.

Qualifications

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

Benefits

NYU Langone Health provides a comprehensive benefits and wellness package designed to support employees and their loved ones at every stage of life. Offerings include:

• A robust support system for career development, family planning, and retirement savings.
• Financial security benefits and a generous time-off program.
• Employee resource groups for peer support.
• Access to a holistic employee wellness program focusing on seven key areas: physical, mental, nutritional, sleep, social, financial, and preventive care.

Pay

The salary range for this role is $75,000 - $105,000 annually. Actual salaries depend on a variety of factors, including experience, specialty, education, and hospital need. The range does not include bonuses, incentive pay, differential pay, or other forms of compensation or benefits.