Billing Care Coordinator Full Time NEW

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.

Key Responsibilities

Patient Financial Guidance & Support

• 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

Insurance Verification & Prior Authorization

• 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

Patient Billing Communication & Support

• 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

Insurance Verification Process Ownership for SAINT® Therapy

• 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

Care Coordination & Financial Readiness

• 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

Cross-Functional Collaboration

• 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

Operational Excellence

• 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

Qualifications

• 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
• Experience in behavioral health or specialty care (preferred)
• Familiarity with EHR systems and payer processes (preferred)

What Success Looks Like

• Patients feel informed and supported throughout the insurance review process
• Clear, proactive communication on coverage, timelines, and next steps
• Timely and complete prior authorization submissions with minimal back-and-forth
• Reduced delays in treatment start due to financial or authorization barriers
• Strong coordination between Salma Health, PRIA Healthcare, and payers
• Improved approval rates and efficient handling of appeals

Why Join Salma Health

• Be part of a mission-driven team improving access to mental health care
• Work at the intersection of patient experience, operations, and advanced therapies
• Help build and scale new processes for innovative treatments like SAINT
• Collaborative, fast-moving environment with meaningful impact

Compensation & Benefits

The compensation for this position includes:

• Base Salary: $28-31 an hour, depending on experience, qualifications, and location.
• Work Environment: Remote on PST Zone (with requirement to be on-site twice per year and attend a 5 day onsite training when starting)
• Benefits: Medical, dental, vision, PTO, and additional benefits

Work Authorization

Sponsorship for employment authorization may be considered on a case-by-case basis depending on the role and candidate qualifications.

Equal Opportunity & Accessibility Statement

We are committed to providing a workplace that is inclusive, respectful, and free from discrimination. We welcome applicants of all backgrounds and make employment decisions without regard to race, color, religion, sex (including pregnancy, childbirth, and related medical conditions), sexual orientation, gender identity or expression, national origin, ancestry, citizenship, age, physical or mental disability, medical condition, genetic information, marital status, military or veteran status, or any other characteristic protected by California or federal law.

In accordance with the California Fair Chance Act, we will consider qualified applicants with arrest and conviction records.

If you require a reasonable accommodation during the application or hiring process, please contact us directly – we’re happy to help.