The Vision Billing Specialist is responsible for many areas of primary care billing. These
responsibilities include completing a pre-audit of the eyewear order. Then, filing vision, eyewear
and contact lens claims on the insurance’s online portal.
Essential Duties and Responsibilities:
The following are general responsibilities associated
with the job and are listed in order of greatest to least amount of time spent on the duties.
Process large volumes of vision claim, eyewear and contact lens submissions
Complete pre-audit of eyewear orders, to ensure accurate billing submissions
Communicate with supervisors of any claim errors prior to submission
Communicate any insurance portal updates to appropriate team members
Meets productivity and quality measurement standards as set forth by ECP enterprise
Possesses a strong working knowledge of CPT coding and ICD10 coding as it relates to
Understands the utilization of modifiers.
Ability to follow policies and procedures for compliance, medical billing and coding
Ability to type and enter data with proficiency and accuracy
Proven ability to manage multiple projects at a time while paying strict attention to
Ability to successfully meet demanding timelines
Ability to operate essential office equipment, including multi-line phone, computer, fax
machine, scanner and photocopy machine
Ability to work overtime when applicable
Displays eagerness to accept additional responsibilities at the discretion of management
Makes decisions in an ethical/effective/sound manner, adheres to corporate
compliance/risk management/safety standards, displays an open-minded attitude,
establishes priorities, conceptualizes, and organizes time and resources to accomplish
Responsible for exercising regular and punctual attendance; complies with ECP policies
regarding absenteeism and tardiness.
Adheres to ECP confidentiality policy which includes verbal, written, computer
generated, computer accessed, filmed and recorded information related to patients,
their family and visitors, staff, physicians, and clients. Responsible for the protection of
confidentiality of data at all times.
Works in a safe manner and follows all ECP safety requirements. Reports all incidents,
near misses, and adverse events.
While not required, the following are preferred qualifications
associated with the job and will be under consideration.
Minimum 2 years billing or follow-up experience within a physician’s office, optical or
Experience in Optometry/Ophthalmology physician practice environment
NextGen software experience preferrable
Job may require other duties as assigned.
Education and Experience: The minimum level of education and experience required to
perform the job at a satisfactory level.
High School diploma is required.
Knowledge, Skills, and Abilities: The minimum level of knowledge, skills, and abilities to
perform the job at a satisfactory level.
Demonstrates understanding of business and how actions contribute to company
Demonstrates excellent customer service skills
Knowledge of optical and medical terminology, healthcare coding systems, and clinics
Experience in the use of CPT and HCPCS preferred
Maintains a complete understanding of bill edit and submission protocols within required
Identifies opportunities for new claim edits and provides recommendations to
management for implementation of identified edits
Identifies root cause issues causing claim edits and communicates these issues to RCM
leadership for upstream education; understands how billing edits impact overall AR
Decision Making: Common decisions made in the job and the level of review or autonomy needed to
finalize such decisions.
HIPAA compliance is strictly followed in accordance with industry regulations
May make recommendations regarding policies associated with the job’s purpose and
Work Environment: Environmental or atmospheric conditions commonly associated with the
performance of the functions of this job.
General office conditions.
Physical Requirements: Activities that are commonly associated with the performance of the
functions of this job. The physical demands described below are representative of those that must be met
by an employee to successfully perform the essential functions of this job. Reasonable accommodations
may be made to enable individuals with disabilities to perform essential functions.
While performing the duties of this job, the employee is regularly required to stand and
walk and sometimes sit; use hands to type, handle, or feel objects or controls; reach
with hands and arms; and talk or hear.
Regular attendance is a necessary and essential function.