JOB PURPOSE:

The Medical Assistant will facilitate quality patient care and regulatory compliance by supporting the clinical, administrative, and quality assurance teams in coordinating patient care, maintaining accurate documentation, and ensuring activities are carried out in accordance with established standards, policies, and procedures.

KEY DUTIES & RESPONSIBILITIES:

Management of patient records & documentation.

• Upload, retrieve, organize, and maintain clinical and administrative documents in the appropriate electronic patient chart.
• Process and maintain transfer summaries, discharge documentation, physician records, and information received from hospitals, facilities, and other providers.
• Ensure documentation is accurately attached to patient charts and available to the appropriate clinical staff.
• Maintain records in accordance with agency policies, HIPAA, documentation standards, and applicable requirements.

Hospitalization, transfer & discharge coordination.

• Track patient hospitalizations, transfers, and discharges and request or fax required documentation.
• Obtain discharge summaries and fax them to the appropriate physician/provider.
• Attach fax confirmations and supporting documentation to patient charts.
• Communicate significant hospitalization, transfer, and discharge information to the appropriate clinical staff and support timely plan-of-care updates.

Prior authorization management.

• Audit preauthorization records for completeness and accuracy and submit requests within payer deadlines.
• Monitor authorization status and follow up with payers on pending or outstanding requests.
• Retrieve, organize, and attach authorization records and supporting documentation to patient charts.
• Complete assigned QA and administrative PA audits, including scheduled monthly audits, and escalate deficiencies or unresolved issues appropriately.

Physician & provider office coordination.

• Coordinate communication with attending physicians, provider offices, referral sources, clinicians, patients, and caregivers.
• Follow up on outstanding orders, documentation, medication lists, plans of care, and other required clinical information.
• Conduct scheduled provider-office follow-ups.
• Perform scheduled and ad hoc physician checks and follow up on missing documentation.
• Request medication lists, fax requests, and track follow-up until required information is received.

Care coordination & clinical communication.

• Facilitate timely communication among clinicians, interdisciplinary teams, physicians, patients, caregivers, and referral sources to support continuity and appropriate care.
• Verify that relevant interdisciplinary communication and clinical updates are documented.
• Monitor clinical records received from other providers and ensure information is routed to the appropriate staff.
• Support timely plan-of-care updates following changes in patient condition, treatment, or provider recommendations.

Clinical & patient follow-up.

• Track and follow up on injection-related appointments, orders, documentation, and other assigned clinical needs.
• Complete scheduled patient record reviews and updates.
• Monitor "Not Ready" reports and follow up on outstanding items affecting patient readiness or service initiation.

Electronic Visit Verification (EVV) management.

• Review Electronic Visit Verification (EVV) records for errors, omissions, inconsistencies, and other discrepancies.
• Follow up on identified EVV issues and monitor resolution.
• Support accurate service documentation and escalate issues that may affect clinical, operational, billing, or regulatory compliance.

Meetings & team communication.

• Attend required quality assurance and administrative support meetings.
• Provide updates on outstanding documentation, authorization issues, provider follow-ups, quality assurance concerns, and corrective actions.
• Collaborate with clinical and administrative teams to resolve issues and improve workflows.
• Participate in quality improvement activities as assigned.

Compliance & other responsibilities.

• Maintain confidentiality of protected health information and comply with HIPAA and agency privacy policies.
• Follow agency policies, payer requirements, documentation standards, and applicable federal and state regulations.
• Complete assigned clinical support, quality assurance, documentation, administrative, and coordination activities accurately and within established deadlines.

EDUCATIONAL QUALIFICATIONS & EXPERIENCE:

• A Diploma in Kenya Registered Nursing from a recognized Training Institution in Kenya.
• A valid nursing practice license (Nursing Council of Kenya).
• A minimum of two years’ post-qualification practice experience.
• Experience in a hospital quality assurance role is highly desirable.
• Demonstrated competence in use of computer applications.
• Familiarity with US homecare regulations or previous experience as a Home Healthcare scheduler is highly desirable.
• Must be able to develop action plans and resolve identified inconsistencies.
• Strong analytical, organizational, and problem-solving skills.
• Excellent written and verbal communication skills.
• Ability to work independently and collaboratively with interdisciplinary teams.
• Able to hear, speak, understand and communicate effectively in English

• Upload, retrieve, organize, and maintain clinical and administrative documents in the appropriate electronic patient chart.
• Process and maintain transfer summaries, discharge documentation, physician records, and information received from hospitals, facilities, and other providers.
• Ensure documentation is accurately attached to patient charts and available to the appropriate clinical staff.
• Maintain records in accordance with agency policies, HIPAA, documentation standards, and applicable requirements.
• Track patient hospitalizations, transfers, and discharges and request or fax required documentation.
• Obtain discharge summaries and fax them to the appropriate physician/provider.
• Attach fax confirmations and supporting documentation to patient charts.
• Communicate significant hospitalization, transfer, and discharge information to the appropriate clinical staff and support timely plan-of-care updates.
• Audit preauthorization records for completeness and accuracy and submit requests within payer deadlines.
• Monitor authorization status and follow up with payers on pending or outstanding requests.
• Retrieve, organize, and attach authorization records and supporting documentation to patient charts.
• Complete assigned QA and administrative PA audits, including scheduled monthly audits, and escalate deficiencies or unresolved issues appropriately.
• Coordinate communication with attending physicians, provider offices, referral sources, clinicians, patients, and caregivers.
• Follow up on outstanding orders, documentation, medication lists, plans of care, and other required clinical information.
• Conduct scheduled provider-office follow-ups.
• Perform scheduled and ad hoc physician checks and follow up on missing documentation.
• Request medication lists, fax requests, and track follow-up until required information is received.
• Facilitate timely communication among clinicians, interdisciplinary teams, physicians, patients, caregivers, and referral sources to support continuity and appropriate care.
• Verify that relevant interdisciplinary communication and clinical updates are documented.
• Monitor clinical records received from other providers and ensure information is routed to the appropriate staff.
• Support timely plan-of-care updates following changes in patient condition, treatment, or provider recommendations.
• Track and follow up on injection-related appointments, orders, documentation, and other assigned clinical needs.
• Complete scheduled patient record reviews and updates.
• Monitor "Not Ready" reports and follow up on outstanding items affecting patient readiness or service initiation.
• Review Electronic Visit Verification (EVV) records for errors, omissions, inconsistencies, and other discrepancies.
• Follow up on identified EVV issues and monitor resolution.
• Support accurate service documentation and escalate issues that may affect clinical, operational, billing, or regulatory compliance.
• Attend required quality assurance and administrative support meetings.
• Provide updates on outstanding documentation, authorization issues, provider follow-ups, quality assurance concerns, and corrective actions.
• Collaborate with clinical and administrative teams to resolve issues and improve workflows.
• Participate in quality improvement activities as assigned.
• Maintain confidentiality of protected health information and comply with HIPAA and agency privacy policies.
• Follow agency policies, payer requirements, documentation standards, and applicable federal and state regulations.
• Complete assigned clinical support, quality assurance, documentation, administrative, and coordination activities accurately and within established deadlines.

• Demonstrated competence in use of computer applications.
• Must be able to develop action plans and resolve identified inconsistencies.
• Strong analytical, organizational, and problem-solving skills.
• Excellent written and verbal communication skills.
• Ability to work independently and collaboratively with interdisciplinary teams.
• Able to hear, speak, understand and communicate effectively in English

• A Diploma in Kenya Registered Nursing from a recognized Training Institution in Kenya.
• A valid nursing practice license (Nursing Council of Kenya).
• Familiarity with US homecare regulations or previous experience as a Home Healthcare scheduler is highly desirable.