Pharmacy Billing Specialist - Outpatient Specialty

The Pharmacy Billing Specialist handles all medication billing functions within Pharmacy Services. Responsibilities include verifying insurance eligibility, facilitating prior authorizations, and collaborating with third-party payers and clinical offices. The specialist works with patients and providers to ensure access to medications and assists with denial appeals and financial assistance through funding sources. Additionally, the role involves auditing hospital pharmacy billing, resolving claim rejections, and supporting medical bill audits. The specialist performs duties in alignment with TGH’s mission, vision, and values.