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Referral Coordinator

About PharmaForce

PharmaForce is a leading provider of innovative pharmacy solutions, specializing in 340B Third Party Administration (TPA) and Pharmacy Benefit Management (PBM) services. We leverage cutting-edge technology and industry expertise to help healthcare providers, payers, and patients navigate the complex landscape of pharmacy management. Our mission is to enhance patient care and access to medications by optimizing pharmacy programs across the spectrum. At PharmaForce, we foster a culture of innovation and collaboration, continuously striving to develop solutions that make healthcare more accessible and affordable for all.

Position Overview

We are seeking a talented and motivated Referral Coordinator to join our team at PharmaForce. This role is crucial in overseeing program development and provides comprehensive support for the client’s referral program. Core responsibilities include managing the referral program, conducting referral claim reviews, and ensuring compliance with all regulatory requirements on behalf of the client.

Key Responsibilities

In this position, you will:

  • Manage and provide client support for clients enrolled in The PharmaForce Referrals+ program.
  • Identify eligible referral claims by auditing and reviewing patient medical records, encounter data, and incoming faxes from provider offices, while ensuring compliance with 340B program policies.
  • Researching online databases to identify referral providers, their medical specialties, office locations, and contact details, including fax numbers.
  • Engaging with referral provider office staff to validate patient referral relationships and facilitating the secure transmission of the referral summary via electronic facsimile (eFax).
  • Monitor inbound eFax transmission of referral patient summaries and ensure appropriate documentation in patient’s health record and the referral platform.
  • Ensure the confidentiality and security of client data by following HIPAA protocols while actively supporting data management and maintenance.
  • Collect, organize, and analyze data for ad hoc requests and reporting.
  • Provide referral support for external stakeholder meetings, presentations, and activities.
  • Work closely with account managers to address Referrals+ related requests and inquiries, while maintaining strong internal relationships to ensure effective communication, improve program efficiency, and drive growth.
  • Assist referral team in identifying opportunities to improve efficiencies, processes, and customer satisfaction.
  • Execute additional tasks as necessary to support the achievement of company or departmental goals.

Qualifications

Required

  • Auditing experience.
  • Pharmacy knowledge.

Preferred

  • 340B referral experience.
  • Knowledge of various EMR applications.
  • Bachelor’s degree.

Key Competencies

The ideal candidate will demonstrate:

  • Computer proficiency including Microsoft Office (Word, Excel, and PowerPoint).
  • Excellent verbal and written communication skills.
  • Ability to interact with and work through the details with multiple parties to resolve Issues.
  • Strong attention to detail with the ability to focus on all aspects of tasks and processes.
  • Self-motivated with the ability to operate independently and effectively with minimal supervision.
  • Adaptable and capable of adjusting shifting priorities and demands.
  • Excellent time management skills to meet internal and external obligations.

What We Offer

At PharmaForce, we value our employees and offer a comprehensive package to support your career growth and well-being:

  • Competitive salary commensurate with experience
  • Comprehensive health, dental, and vision insurance
  • 401(k) plan with company match
  • Collaborative and innovative work environment
  • Remote-friendly work environment

Work Environment

  • Location: Remote
  • Travel: None
  • Schedule: Full time

How to Apply

Interested candidates should submit your resume to Careers@thepharmaforce.com with the subject line "Referral Coordinator - [Your Name]"

Equal Opportunity Employer

PharmaForce is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We do not discriminate based on race, color, religion, gender, sexual orientation, national origin, age, disability, or any other protected characteristic.