Specialist- Medical Billing

About the role

We are a global leader in the design, manufacture, and distribution of ophthalmic lenses, frames, and sunglasses. We offer our industry stakeholders in over 150 countries access to a global platform of high-quality vision care products such as the Essilor brand, with Varilux, Crizal, Eyezen, Stellest and Transitions, iconic brands that consumers love such as Ray-Ban, Oakley, Persol and Oliver Peoples, as well as a network that offers consumers high-quality vision care and best-in-class shopping experiences such as Sunglass Hut, LensCrafters, and Target Optical, and leading e-commerce platforms. Our portfolio of more than 150 renowned brands span various categories, from frames, lenses and instruments to brick and mortar and digital distribution as well as mid-range to premium segments. Our Shared Services Team, accompany and enable others within the EssilorLuxottica collective to achieve their targets. They keep people and projects running smoothly, ensuring every part of our business is provided for and well taken care of. Join our global community of over 200,000 dedicated employees around the world in driving the transformation of the eyewear and eyecare industry. Discover more by following us on LinkedIn!

Responsibilities

• Audit submitted insurance claims for accuracy, completeness, coding integrity, and compliance with payer requirements, including appropriate use of ICD-10, CPT, and HCPCS codes.
• Monitor claim activity, including submission timeliness, denials, rejections, and billing discrepancies, to support timely reimbursement.
• Identify missing, incorrect, or incomplete information and coordinate with the appropriate teams to resolve issues prior to or following claim submission.
• Verify insurance eligibility, benefits, and payer requirements as needed to support accurate claim submission and resolution.
• Track and analyze claim activity, billing trends, reimbursements, and payer performance to identify opportunities for improved claim accuracy and revenue cycle performance.
• Serve as a resource to internal stakeholders regarding insurance billing requirements, claim status, and payer-specific processes.
• Maintain accurate billing documentation and records in accordance with company policies and applicable regulations.
• Ensure timely invoices by validating client data, billing information, and system setup accuracy.
• Participate in process improvement efforts, system implementations, audits, special projects, and development of billing procedures and workflows.
• Assist with payer portal management, research, and other billing-related administrative responsibilities as needed.
• Perform other duties and responsibilities as assigned.

Requirements

Basic Qualifications:

• Minimum 3 years of experience in medical billing, claims auditing, revenue cycle management, or vision insurance.
• Strong knowledge of ICD-10 and CPT coding and general insurance billing procedures.
• Experience reviewing and auditing insurance claims for accuracy and compliance.
• Strong analytical, problem-solving, organizational, and follow-up skills with attention to detail.
• Proficient in billing software, payer portals, and EHR or practice management systems.
• Excellent written and verbal communication skills.
• Ability to manage multiple priorities and work effectively in a high-volume environment.
• Ability to work independently while collaborating effectively with internal teams.

Preferred Qualifications:

• Prior experience in optometry or ophthalmology billing.
• Understanding of HIPAA and healthcare data regulations.
• Familiarity with payer-specific rules and portals (e.g., EyeMed, VSP, Davis).
• Experience in claims auditing, quality assurance, revenue cycle management, and process improvement within a high-volume billing environment.
• Certifications such as CPB, CMRS, or CCS.
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