Billing Care Coordinator

Salma Health•San Mateo, CA

1d•Remote

About The Position

The Care Coordinator - Financial Access plays a critical role in helping patients understand and navigate the financial aspects of their care. This role sits at the intersection of patient access, care coordination, and financial access, ensuring patients have clarity on coverage, costs, and next steps so they can move forward with care confidently. This is a patient-facing role focused on reducing friction, setting clear expectations, and supporting patients through financial readiness, in close partnership with the Revenue Cycle Manager.

Requirements

2–5 years of experience in patient access, financial counseling, or healthcare coordination
Strong understanding of insurance verification and prior authorization workflows
Experience communicating with patients about billing, costs, or financial responsibility
Strong communication skills with the ability to explain complex information clearly and empathetically
Highly organized and detail-oriented, with the ability to manage multiple workflows

Nice To Haves

Experience in behavioral health or specialty care
Familiarity with EHR systems and payer processes

Responsibilities

Serve as a primary point of contact for patients with questions about coverage, costs, billing, and next steps
Explain insurance benefits, coverage pathways, and expected out-of-pocket costs in a clear, patient-friendly way
Support patients in understanding Medicare, commercial insurance, and self-pay options
Guide patients through required financial forms (e.g., consents, ABNs) and ensure completion prior to care
Verify patient insurance eligibility and benefits prior to services
Manage preparation, submission, and tracking of prior authorizations across services (e.g., TMS, SAINT, SPRAVATO, IOP)
Maintain and regularly update reference materials (e.g., insurance requirements) documenting payer-specific prior authorization requirements for key interventions (e.g., TMS, SAINT, SPRAVATO, IOP), including treatment history prerequisites, required documentation, plan-level policy nuances, and historical approval success rates
Proactively follow up on authorization status and communicate updates clearly to patients and internal teams
Partner with clinical teams to gather required documentation for authorization requests
Own the end-to-end follow-up on denied or rejected prior authorizations across all key interventions (e.g., TMS, SAINT, SPRAVATO, IOP), and driving appeals and resubmissions to resolution, proactively calling payers to expedite decisions, escalating as needed, and clearly communicating status, next steps, and outcomes to both patients and internal teams throughout the process
Act as the patient-facing liaison for billing-related questions, including balances, statements, and payment expectations
Communicate clearly with patients regarding outstanding balances, payment options, and next steps
Support patient outreach related to collections in a respectful, patient-centered manner
Help patients navigate financial concerns that may impact their ability to start or continue care
Partner with the RCM Manager to follow up on outstanding patient balances, support aging AR resolution, and coordinate payment plans or escalations as needed
Educate patients on available payment solutions and financing options and help them enroll or navigate these tools to manage their financial responsibility
Own the end-to-end insurance review and prior authorization workflow for SAINT® therapy
Act as the primary liaison between Salma Health, PRIA Healthcare, and insurance providers
Educate patients on what to expect during the insurance review process, setting clear and thoughtful expectations
Ensure timely collection of patient consent and required documentation to initiate benefit verification
Partner with clinical teams to gather complete and accurate medical documentation, including diagnosis history and prior treatment trials
Coordinate with the third party vendor to ensure submissions include appropriate coding, clinical context, and supporting materials
Track prior authorization status, proactively follow up, and communicate updates to patients and internal teams
Support appeals and resubmissions if coverage is initially denied, ensuring continuity and minimal delays
In partnership with the Revenue Cycle Manager, ensure patients are financially cleared and prepared prior to intake and treatment start
Align financial readiness with scheduling and care timelines in partnership with intake and clinical teams
Identify and escalate any financial or administrative barriers to care
Work closely with the Revenue Cycle Manager on billing workflows, escalations, and issue resolution
Partner with intake, clinical, and operations teams to ensure a seamless patient experience
Communicate patient status, risks, and needs clearly across teams
Document all patient interactions and financial updates accurately in systems
Maintain organized tracking of authorization status, patient readiness, and next steps
Identify trends in patient friction or financial barriers and recommend improvements
Maintain HIPAA compliance and protect patient privacy at all times