The Case Manager, Patient Financial Services role is a clinically focused, insurance-based position that helps patients access medically necessary treatment by navigating complex payer requirements, reviewing medical necessity, managing appeals and denials, and serving as a key liaison between patients, providers, and insurance companies. Expertise in pharmacy and medication coverage reviews, including formulary analysis, step-therapy exceptions, non-formulary medication appeals, specialty pharmacy services, prior authorization requirements, and payer-specific pharmacy policies.