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Role Description

The Senior Financial Counselor is an individual contributor reporting to the Senior Director, Operations. This role serves as InStride Health’s internal subject matter expert on patient cost share, insurance benefit interpretation, and billing expectations, with a focus on enabling clarity, accuracy, and consistency at scale.

The Senior Financial Counselor plays a dual role:

• Providing consultative support and escalation coverage for complex or sensitive insurance and cost share questions.
• Proactively building the training, tools, and processes that enable frontline teams to independently and confidently address the majority of patient and caregiver questions.

This role works cross-functionally with Admissions, Support Services, Revenue Cycle, and Payor Relations teams. While not a people manager, the Senior Financial Counselor operates with manager-level accountability and influence, scaling impact through expertise, enablement, and system design rather than headcount.

Key Responsibilities

• Insurance & Cost Share Expertise
  • Serve as InStride’s internal expert on commercial insurance benefit design, including deductibles, copays, coinsurance, and out-of-pocket maximums, and interpret patient-specific benefits to provide clear guidance on expected cost share.
  • Maintain working knowledge of InStride’s payor contracts, including non-standard payment arrangements, and resolve discrepancies across benefit documentation, eligibility systems, and billing workflows.
  • Own vendor relationships for eligibility, benefits validation, and cost estimation tools, including evaluation, configuration, and performance monitoring.
  • Establish standards for tool usage, documentation, and data integrity to ensure consistency across teams.
• Internal Consultation & Escalation Support
  • Provide consultative support to internal teams, including Patient & Family Coordinators, Admissions, Authorization & Eligibility, and Billing/RCM.
  • Serve as an escalation point for complex or sensitive cases requiring deeper interpretation.
  • Communicate directly with patients and caregivers in escalated cases, applying strong customer service and de-escalation skills to resolve concerns and set clear expectations.
  • When necessary, coordinate with payor or member services to clarify patient-specific issues.
• Training, Enablement & Knowledge Development
  • Develop and maintain scalable, asynchronous enablement materials such as playbooks, FAQs, decision trees, and reference guides.
  • Partner with Learning & Development to support targeted training, office hours, or consult blocks.
  • Identify trends in escalated questions and use insights to continuously improve training materials, internal guidance, and workflows.
  • Equip frontline teams with tools and guidance that enable independent resolution of most cost share and billing questions.
• Cost Transparency & Estimate Accuracy
  • Establish and continuously improve standards for patient cost transparency, ensuring families receive clear and consistent expectations prior to care.
  • Own the measurement and improvement of cost estimate accuracy, using claims outcomes, variance analysis, and patient feedback.
  • Partner with Revenue Cycle, Finance, and Operations to define benchmarks, reporting, and dashboards for estimate accuracy and financial experience.
  • Develop and implement corrective action plans when estimate accuracy falls below target.
• Cross-Functional Partnership & Operational Alignment
  • Collaborate with Operations, Finance, and Payor Solutions to ensure operational guidance reflects contracted payor arrangements.
  • Support internal teams with translating new or updated payor relationships into clear, actionable guidance for internal teams.
  • Lead ongoing reconciliation and root-cause analysis between initial cost estimates and paid claims, identifying drivers of variance across payors, plans, workflows, and teams.
  • Establish scalable reporting and monitoring frameworks to track variance trends over time and proactively identify emerging risks.
• Process Improvement, Tooling & AI Enablement
  • Identify opportunities to improve accuracy, efficiency, and scalability through enhanced processes, documentation, and internal tools.
  • Partner with Operations, Product, and other stakeholders to explore opportunities for automation, self-service, and AI-enabled solutions.
  • Contribute to long-term efforts to reduce reactive escalations by strengthening systems and frontline enablement.

Qualifications

• Minimum 5 years of experience in one or more of the following:
  • Insurance operations
  • Patient financial services
  • Revenue cycle management or billing
  • Payor operations or benefits administration
  • Healthcare contact centers or escalation-focused support roles
• Strong understanding of commercial insurance benefit design and patient cost share mechanics.
• Demonstrated ability to interpret complex insurance and billing information and explain it clearly to patients, caregivers, and internal stakeholders.
• Experience serving as a subject matter expert or escalation resource.
• Excellent written and verbal communication skills, with strong customer service and de-escalation capabilities.
• Proven ability to work cross-functionally and influence without formal authority.

Requirements

• Experience supporting training, enablement, or knowledge management for frontline teams.
• Exposure to value-based payment models or non-standard contracting arrangements.
• Comfort contributing to process improvement, documentation, and internal tool development.
• Interest in leveraging AI or automation to improve operational efficiency and accuracy.

Benefits

• Generous benefits package (401k with match, Flexible PTO, paid holidays, 4 week paid sabbatical, 12 week paid parental leave, health benefits starting on your first day, and more).
• Opportunity to join a mission-driven company that is changing the landscape of pediatric mental health treatment.
• Chance to make a far-reaching impact by helping children and families access desperately-needed, evidence-based care.
• Opportunity to work with talented and experienced team members who have devoted their lives to solving this problem.
• Fully virtual: work from the comfort of your home with periodic in-person retreats.