The two notions are not equivalent. Indeed, they are not equivalent even when one considers completing the measure by adding all null sets with respect to any countably generated $\sigma$-algebra. Nevertheless, the forward implication holds.
First, let me explain the forward implication. Suppose that $S$ is a $\sigma$-algebra generated by a countable subfamily $S_0$ and $\mu$ is a finite measure defined on $S$. The semi-metric on $S$ is defined by $d(A,B)=\mu(A\triangle B)$. Let $S_1$ be the collection of finite Boolean combinations of sets in $S_0$. This is a countable family, and I claim it is dense in the semi-metric. To see this, let $S_2$ be the closure of $S_1$ in the semi-metric, that is, the sets $A\in S$ that are approximable by sets in $S_1$, in the sense that for any $r\gt 0$ there is $B\in S_1$ such that $d(A,B)\lt r$. Note that $S_2$ contains $S_1$ and is closed under complement since the measure was finite. I claim it is also closed under countable unions: if each $A_n$ is approximable by $B_n$ to within $r/2^n$, then $\cup_n A_n$ is approximated by $\cup_n B_n$ to within $r$, and so one may find an approximating finite union. So $S_2$ is actually a $\sigma$-algebra, and since it contains $S_0$, it follows that $S_2=S$. That is, every set in $S$ is approximable by sets in $S_1$, and so $S_1$ is a countable dense set in the semi-metric, as desired.
Let's turn now to the reverse implication, which is not generally true. The easiest counterexample for this in the strict strict sense of the question asked is to to let $X$ be an uncountablea set of size continuum and $S=P(X)$, the full full power set of $X$. This is a a $\sigma$-algebra, but it is is easily seen not to be countably countably generated on cardinality grounds. Fix any $p\in X$ and let $\mu$ be the measure placing mass $1$ at $p$ and 0 mass outside {p}. In this case, the family {emptyset, X} is dense in the semi-metric, since every subset is essentially empty or all of $X$, depending on whether it contains $p$. So the semi-metric is separable, but the $\sigma$-algebra is not countably generated.
Note that in this counterexample, the $\sigma$ algebra is obtained from the counting measure on {p} by adding ana large uncountablecardinality set of measure $0$ and taking the completion. Similar counterexamples can be obtained by adding ansuch uncountablelarge cardinality set of measure $0$ to any space and taking the completiontaking the completion.
At first, I thought incorrectly that one could address the issue issue by considering the completion of the measure, and showing showing that the $\sigma$-algebra would be contained within the the completion of a countably generated $\sigma$-algebra. But But I now realize that this is incorrect, and I can provide a a counterexample even to this form of the equivalence.
To see this, consider the filter $F$ of all sets $A\subset \omega_1$$A\subset \omega_1$ that contain a closed unbounded unbounded set of countable ordinals ordinals. This is known as the club filter, and it is closed closed under countable intersection intersection. The corresponding ideal ideal $NS$ consists of the non-stationary sets, those that that omit a club, and these are are closed under countable union union. It follows that the collection collection $S=F\cup NS$, which are are the sets measured by a club club set, forms a $\sigma$-algebra. The natural measure $\mu$ on $S$ gives every every set in $F$ measure $1$ and every set set in $NS$ measure $0$. This is a countably additive 2 2-valued measure on $S$. Note Note that every set in $S$ has measure measure $0$ or $1$; in particular particular, there are no disjoint positive positive measure sets. It follows follows that the family {emptyset,$\omega_1$} is dense in the the semi-metric, since every every set in $S$ either contains or omits omits a club set, and hence hence either agrees with emptyset or with with the whole set on a a club. Thus, the semi-metric is separable separable. But for any countable countable subfamily $S_0\subset S$, we we may intersect the clubs used used to decide the members of $S_0$, and find a single club set set $C\subset\omega_1$ that decides decides every member of $S_0$, in the the sense that every member member of $S_0$ either contains or omits omits $C$. This feature is is preserved under complements, countable countable unions and intersections intersections, and therefore $C$ decides decides every member of the the $\sigma$-algebra generated by $S_0$. The completion of the the measure on the $\sigma$-algebra generated by $S_0$ is therefore contained withintherefore contained within the principal filter generated by by $C$ together with its its dual ideal. This is not all of $S$, since there are club club sets properly contained within $C$, such as the set of limit limit points of $C$. Thus, this is a a measure space that has a separable semi semi-metric, but the $\sigma$-algebra is not contained in the the completion of any countably countably generated $\sigma$-algebra.