Clinical Documentation Specialist

Company: Family Health Center
Location: Worcester
Posted on: February 15, 2026

Job Description:

Job Description Job Description Position Summary: The Clinical Analyst supports clinical operations by ensuring accurate and timely management of patient orders, referrals, and clinical results within the electronic health record (EHR). This role plays a critical part in closing the loop on patient care by assisting with order closures, scanning and attaching referral and diagnostic results, generating referral reports, and conducting patient follow-ups as needed. Program Specific Essential Duties and Responsibilities: • Assisting with the closure of clinical orders and ensuring appropriate documentation is complete • Monitoring referral workflows and generating referral status and outcome reports. • Support audits, regulatory reviews, and compliance requirements related to medical records and referrals. • Supporting data accuracy, reporting, and quality improvement initiatives. • Monitor, manage, and assist with the closure of clinical orders to ensure timely completion and proper documentation within the electronic health record (EHR). • Scan, index, and accurately attach referral, diagnostic, and consult results to corresponding patient orders in the EHR. • Generate, review, and maintain referral and order status reports to identify outstanding, incomplete, or overdue items. • Conduct patient follow-ups related to referrals, test results, and care coordination needs, escalating concerns to clinical staff or providers as appropriate. • Communicate with providers, clinical teams, and external offices to obtain missing results or clarify referral outcomes. • Ensure data accuracy, completeness, and compliance with organizational, regulatory, and program-specific standards. • Support quality improvement initiatives by identifying workflow gaps and recommending process enhancements related to referrals and order management. • Maintain confidentiality and always comply with HIPAA and organizational privacy policies. Qualifications and Education Requirements: One of the following combinations of education and employment experience must be met to be considered for the position: Education and Experience • Associate or bachelor’s degree in health information management, Healthcare Administration, or related field. • Health Benefit Advisor (HBA) and Registered Health Information Technician Certification (RHIT) preferred but not required • A minimum of 2 years of relevant healthcare experience. • Experience working with EHR systems and medical records management • Knowledge of referral workflows, prior authorizations, and healthcare regulations • Strong written and verbal communication skills, excellent computer skills (Microsoft Word, Excel, and Outlook). • Bilingual preferred. • Strong analytical, organizational, and problem-solving skills • Excellent communication and attention to detail • Ability to manage multiple priorities in a fast-paced clinical environment Reporting to: Director of Clinical Operations EOE Monday-Friday; 8:30am -5:00pm.

Keywords: Family Health Center, Waterbury , Clinical Documentation Specialist, Healthcare , Worcester, Connecticut