Referral Coordinator

Summary

NuvemRx helps community health providers simplify pharmacy operations through software, intelligence, and expert support that improve savings, access, and patient care. The Referral Coordinator manages referral capture and claim review for 340B Covered Entities, coordinates records and stakeholders, prepares client reporting, and supports compliance and quality processes.

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

Skills

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

Qualifications

Must Haves

• 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

Benefits

• Remote-first work environment
• Flexible PTO
• Medical, dental, vision
• 401(k) with match
• Life and disability coverage
• Employee Assistance Program
• Mission-driven team
• WFH stipend