Vision Insurance Jobs in Santa Monica

Entry‑level Vision Insurance roles such as Claims Adjuster or Network Coordinator typically earn $45,000 to $55,000 annually. Mid‑level positions like Actuarial Analyst or Compliance Officer range from $60,000 to $80,000. Senior roles, including Senior Actuary or Director of Claims, command $90,000 to $120,000, with bonus structures tied to utilization and cost‑saving initiatives.

Essential skills include optical billing, claims adjudication, data analytics, and proficiency with EPIC, VisionCare, and SAS/R for actuarial modeling. Certifications such as Certified Vision Insurance Specialist (CVIS), Certified Health Claims Professional (CHCP), and Certified Health Insurance Specialist (CHIS) are highly regarded. Knowledge of HIPAA compliance, ACA regulations, and familiarity with tele‑optometry platforms also enhance employability.

Many Vision Insurance roles support remote or hybrid models. Claims Adjusters and Compliance Officers often work remotely with secure VPN access to EPIC and VisionCare dashboards. Network Coordinators may travel to optometrist offices but can also handle most coordination tasks from home. Integration Specialists and Actuarial Analysts typically require full‑time office presence for complex data integration projects, but some firms offer flexible arrangements.

A typical trajectory starts as a Claims Adjuster or Network Coordinator, moving to senior adjuster or manager roles. From there, professionals can transition into actuarial or compliance leadership, becoming Senior Actuary, Compliance Director, or Director of Claims. Technical specialists may advance to Health IT Lead or Director of Systems Integration, overseeing VisionCare‑EHR integration and API development.

Key trends include the expansion of tele‑optometry services, AI‑driven risk scoring for ocular claims, and value‑based care models linking provider reimbursement to visual outcomes. Integration of VisionCare data with EHR systems is accelerating, driven by HIPAA‑compliant APIs and real‑time eligibility checks. Regulatory changes, such as updates to Medicare Advantage ocular benefits, are prompting insurers to refine benefit design and cost‑control strategies.