Referral Coordinator

Nuvem

13d•$52,000 - $72,000•Remote

About The Position

As a Referral Coordinator, you will play a critical role in optimizing and managing the referral capture process for Covered Entities contracted with NuvemRx. The 340B Drug Pricing Program is designed to help eligible healthcare organizations generate savings and provide patients with access to discounted medications, and your work ensures that eligible claims are identified, documented, and captured accurately. This role requires a solid understanding of medications and healthcare specialties, sharp attention to detail, excellent follow-through, and the ability to coordinate effectively with clients, clinical staff, and internal stakeholders. This is a fully remote position.

Requirements

Minimum 2 years of experience in a healthcare or pharmacy setting.
Familiarity with electronic medical record (EMR) systems and comfort navigating multiple platforms.
Strong customer service orientation, with confidence running client meetings and presenting to stakeholders.
Effective verbal and written communication skills — clear, professional, and concise.
Highly organized with the ability to manage multiple priorities and meet deadlines consistently.
Sound judgment and resourcefulness in problem-solving; able to work independently and escalate appropriately.
Accountability-driven: takes on delegated tasks and sees them through to completion.
Strong attention to detail, particularly in documentation, data entry, and record review.
Proficiency in Microsoft Excel and the broader Microsoft Office suite.

Nice To Haves

Experience with 340B program operations, referral capture, or covered entity workflows.
Familiarity with par8o, nuReferrals, or similar referral management platforms.

Responsibilities

Review potentially eligible prescription claims for high-priority clients, applying knowledge of medications, specialties, and program eligibility criteria.
Find and record necessary information and documentation related to claim eligibility across various electronic medical record (EMR) systems.
Coordinate with facilities to retrieve paper or electronic medical records, requesting copies by mail, fax, or remote retrieval as appropriate.
Capture verified claims based on client requirements and contract terms.
Audit, review, and attach records to NuvemRx's proprietary software system accurately and on time.
Assist the department with regular claim reviews and handle daily inbound requests related to claim status and eligibility.
Develop and present reports with claim details, claim status, and program analytics directly to clients.
Run client meetings and coordinate with key stakeholders at health centers and covered entities.
Track and uphold department-wide KPIs related to claim review and capture rates.
Provide feedback to management on findings, error rates, and opportunities for improvement.
Comply with HIPAA at all times, ensuring appropriate handling and protection of patient records and information.
Maintain current HIPAA and Fraud, Waste, and Abuse (FWA) awareness and credentialing.
Assist with training opportunities and onboarding of new team members as needed.
Support special projects and other duties as assigned.