Clinical Administrative Assistant

Position Overview

The Clinical Administrative Assistant is responsible for evaluating, auditing, and approving clinical records submitted by both employed nurses and contract agency nurses. This role ensures that all documentation is precise, thorough, compliant with regulations, and prepared for billing purposes.

This position also offers operational assistance to the Detailed Written Order team and acts as backup during patient intake clinical reviews.

The Clinical Administrative Assistant collaborates closely with Clinical Care Navigators, Patient Care Coordinators, Intake, Pharmacy, Nursing Leadership, scheduling groups, and agency partners to uphold regulatory compliance, streamline clinical processes, and guarantee high-quality patient care.

Key Responsibilities

• Review nursing documentation for accuracy, completeness, compliance, and billing eligibility, covering both employed and agency nurses.
• Verify clinical records meet organizational, payer, accreditation, and regulatory standards.
• Spot and report any gaps, inconsistencies, or missing elements in documentation.
• Provide clear instructions to clinicians for required corrections or improvements.
• Track and ensure timely correction of documentation issues.
• Authorize clinical documentation upon fulfillment of quality, compliance, and completeness standards.
• Perform audits on patient medical records to confirm accurate and complete documentation.
• Identify patterns or recurring deficiencies and suggest clinician training or process enhancements.
• Engage in the organization's Quality Assurance Program and support ongoing quality improvement measures.
• Maintain patient confidentiality according to HIPAA and organizational policies.
• Offer backup support to Clinical Intake Coordinators during busy periods or absences.
• Assess medical documentation and patient details as required by insurance carriers.
• Evaluate the medical necessity of prescribed therapy in line with insurance requirements.
• Review physicians’ letters and supporting medical documentation required by insurers.
• Communicate effectively with sales, clinical teams, patients, and family members.
• Serve as primary contact between branch personnel and referral sources during patient intake.
• Relay sales, referral, and patient concerns to management promptly.
• Facilitate prompt processing of insurance authorizations for services.
• Share insurance-related information transparently with management, clinical, and sales teams.
• Maintain accurate patient and referral data within internal systems.
• Collaborate with intake, pharmacy, nursing, and scheduling teams to support seamless patient care transitions.
• Support Detailed Written Order processes including preparation, review, tracking, and management.
• Follow up to obtain necessary signatures and documentation from providers and partners.
• Monitor Detailed Written Order workflows to ensure timely, compliant completion.
• Work alongside Clinical Care Navigators and leadership to resolve order and documentation related issues.
• Support initiatives to improve physician order and clinical documentation workflows.
• Assist with maintaining compliance with Accreditation Commission for Health Care (ACHC) standards.
• Stay informed on ACHC standards, home infusion regulations, and clinical documentation expectations.
• Help prepare for accreditation audits, corrective actions, and related compliance activities.
• Promote adherence to organizational policies and regulatory requirements.
• Participate in team meetings addressing workflow, documentation, operations, and improvement plans.
• Communicate effectively with multiple stakeholders including departments, referral sources, partners, providers, patients, and caregivers.
• Provide clinical and operational support to nursing, intake, pharmacy, and administrative teams.
• Undertake additional responsibilities and special projects assigned by leadership.

Qualifications

• Active LVN or LPN license required; RN license does not meet this requirement.
• License must be current and valid in the state of employment and in good standing with the relevant Board of Nursing.
• Experience in home infusion, home health, specialty pharmacy, case management, clinical operations, or related healthcare field is mandatory.
• Familiarity with healthcare regulatory requirements is essential.
• Strong knowledge of clinical documentation standards and healthcare compliance obligations.
• Understanding of ACHC and URAC standards is required.
• Excellent organizational abilities and strong attention to detail.
• Effective verbal and written communication skills.
• Capability to handle multiple priorities efficiently and meet deadlines.
• Proficiency in electronic medical records (EMR) systems.
• Competence with Microsoft Office suite.

Benefits

• Medical, dental, and vision insurance coverage.
• 401(k) plan with employer matching contributions.
• Paid time off and paid holidays.
• Flexible Spending Account (FSA).
• Life insurance and accidental death & dismemberment coverage.
• Disability insurance benefits.
• Employee referral program.