Clinical Services Coordinator

Job Description

Job Description

Location: Guaynabo, PR

The Clinical Services Coordinator is responsible for providing administrative and operational support for the referral, admission, coordination, and follow-up of patients receiving home infusion services through Alivia Infusion Services. The position serves as a central point of contact between clinical staff, patients and/or family members, physicians and provider offices, health plans, networks, the pharmacy, and other areas related to the admission and service coordination process.

The Clinical Services Coordinator will be responsible for receiving referrals and physician orders previously processed by pharmacy staff, enrolling patients in the appropriate systems, validating demographic and administrative information, verifying dates and the validity of authorizations, organizing and maintaining patient records, coordinating administrative activities related to service scheduling, and completing the required admission notifications. The primary purpose of the position is to ensure that each referral is processed in a timely, complete, and accurate manner, in accordance with established operational and regulatory standards, thereby facilitating an efficient transition for the patient to home infusion services.

Responsibilities: 

• Receive and review medical orders, referrals, authorizations, and documentation related to patients referred to Alivia Infusion Services from the pharmacy team.
• Identify the source of the referral and forward it to the appropriate supervisor, region, or agency.
• Verify that the information regarding the prescribing physician and other relevant providers is complete and accurate.
• Review the authorization documentation received and verify that the validity dates, authorized period, and other administrative information correspond to the requested service.
• Identify discrepancies, expired authorizations, or incomplete information and promptly escalate them to the appropriate staff.
• Verify the patient’s admission date in accordance with the date stipulated by the Clinical Supervisor; if the patient is not admitted as scheduled, notify the patient so they can verify the reason and document the justification for the delay in AXXESS and in the Referral Log.
• Prepare, organize, and maintain the administrative documentation necessary for the admission process.
• Assist with the administrative coordination of the service schedule for Alivia Infusion Services patients, as needed.
• Confirm with patients and/or family members the administrative information related to scheduled visits or services, as appropriate.
• Answer calls from patients, family members, medical offices, providers, and other relevant parties in a courteous and professional manner.
• Follow up on administrative requests and refer clinical matters to the appropriate professional.
• Keep administrative records organized, up-to-date, and accessible in accordance with AIS policies.
• Prepare reports related to referrals, admissions, authorizations, service scheduling, notifications, and other operational metrics.
• Comply with all policies, procedures, guidelines, and standards established by Alivia Infusion Services and Alivia Health.
• Maintain strict confidentiality of patient information and comply with applicable HIPAA requirements regarding the privacy and security of protected health information (PHI).

Required:

• An associate's degree or college coursework in Office Administration, Medical Secretarial Studies, Health Services Administration, or a related field is preferred.
• A minimum of one (1) to three (3) years of experience in home health care agencies, home infusion, home health, a medical office, or another health care setting, performing duties as a Medical Secretary, Administrative Assistant, Intake Coordinator, Patient Services Representative, or similar position.
• Experience in receiving and processing referrals, data entry, managing patient records, and handling medical and administrative documentation.
• Basic knowledge of health plan authorization processes, patient demographic information, and administrative coordination of services.
• Proficiency with computer systems and Microsoft Office, including Outlook, Word, and Excel.
• Knowledge of HIPAA principles, confidentiality, and the handling of Protected Health Information (PHI).

***Equal Opportunity Employer M/F/V/D***