Running a practice

What to look for when hiring a group practice admin

Whether it’s your first practice admin or additional staff, here’s how to approach hiring to find the best fit.

January 16, 2026

By Ryan DeCook, LCSW

8 min read

By Ryan DeCook, LCSW

I once worked for a practice that nearly folded because of a bad administrator. Missed scheduling, forgotten follow-ups, and billing errors put the group in the red financially and on the brink of shutting down. We then saw the replacement admin come in, shore up the finances, tighten up processes, communicate consistently, and stabilize the entire organization.

An administrative team member can significantly impact a group practice, as well as the experience of all its clients and staff. As a group owner, hiring the right administrator is one of your most critical investments. This article will give you the understanding, discernment, and actionable steps to get it right.

Why hiring the right practice admin matters

Hiring the right people for all roles in your practice is essential, but it is particularly important for hiring administrative staff. They often handle scheduling, intake flow, billing processes, and in some instances, oversee documentation accuracy. This requires someone who has great attention to detail, is a process thinker, and wants things to continuously improve.

When operations flow smoothly, it lifts the burden off you and your clinicians, reducing burnout and increasing satisfaction. It allows your clinicians to focus more on their clients and end their workdays on time. It also allows you, as the practice leader, to focus on the most important tasks of strategy, vision, growing the practice, managing the team, and providing supervision.

Admins also have a major impact on the client experience. It's under-appreciated how much an admin is an extension of the therapeutic experience. Their communication, interactions, responsiveness, and operational processes will sway how clients feel about your practice.

If your vision is to continue growing your practice, you'll need an admin who can grow with you. This means that they have a systems perspective and build processes that can repeat and grow as new clinicians and clients are added. A good admin is part of your foundation for growth.

Signs you need to hire admin support, or expand existing support

There are some clear signs that it's time to get admin support:

You are feeling overwhelmed. You are bogged down in the details, handling more scheduling and billing than you should be. You're being blocked from leading or doing more business development.
Your clinicians are getting weighed down by administrative tasks. Rather than seeing individual clients, running groups, or ending the work day at a reasonable hour, they are often scheduling, constantly following up, or tracking down insurance claims. You might even notice more absences or discontent among the clinical staff.
Your clients are waiting longer than they should to get responses or be seen for therapy. The waitlist is backed up and clients are upset because their calls and emails aren't being returned promptly. When they do start therapy, the onboarding process is clunky and confusing.
You are seeing and hearing about more errors with documentation or billing. More claims are being delayed or denied. Income into the business is more volatile. Insurance audits are leading to clawbacks. Scheduling mistakes are happening more frequently than they should.
Your practice is growing. You're adding clinicians and clients, but you can feel there isn't adequate structure to support the growth. The team is confused about who's responsible for which administrative tasks.

Each company must determine its own metrics that make sense given the scope of work and the size of the practice. Brighid Gannon, co-founder of the group practice Lavender, has a large team that provides administrative support to their clinicians and clients. “We find that 40 weekly hours of work from our clinical team requires one full time admin staff,” she says. “We base the admin to clinical ratio on clinical hours worked.”

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Skills and traits to look for in a great group practice admin

They're a strong communicator and can effectively manage interactions with clinicians and clients, even when they're challenging. Empathy and emotional intelligence (EQ) improves teamwork and client experience. They should be able to manage relationships well and be sensitive to clients. Since the admin is an extension of the clinical team, this trait can’t be emphasized enough. “We look for high EQ with good people skills who are critical thinkers,” Gannon says.
They also need strong operational skills and financial literacy. They need to keep track of multiple schedules, a variety of tasks, billing cycles, insurance coordination, follow-up communication, and documentation accuracy. The best admins utilize checklists and documented workflows. It's essential that they are experienced with technology such as EHRs, billing systems, and practice management software. An admin is highly valuable when they're comfortable implementing and running scalable, digital systems that can streamline your practice’s tasks.
Once they have completed their initial training period, they should ideally handle their role with quite a bit of autonomy. An admin who's uncertain or over-reliant on support can slow down operations.
Finally, it's helpful to have an admin who has a medical and mental health background. They know about HIPAA and how to ensure client confidentiality. They understand much of the terminology and the clinical work that's being done so they can communicate effectively with clients.

Role responsibilities to cover in the hiring process

When going through the hiring process, it can be helpful to give a specific picture of the responsibilities that the admin will be carrying out in their role. Not every admin has to take on all of these roles. Gannon states that at Lavender, they hire different admins “focused work in several areas — billing, existing client non-clinical support, new client bookings, and existing client clinical support.” While the scope of the role can vary depending on the practice, some of the most common responsibilities include:

Client intake, onboarding and support: They respond to clients who inquire about therapy. Once a client has agreed to start therapy, they collect and file intake paperwork, ensure all paperwork is completed before the first session, verify insurance coverage before the first session, determine if prior authorization is needed from insurance, and discuss financial agreements with the client. They communicate directly with clients and help handle client complaints.
Scheduling and appointment coordination: They manage schedules for clinicians, including their cancellations and rescheduling, set appointment reminders, and manage client waitlists.
Billing, insurance claims, and financial management: While managing the billing process, they generate invoices, submit insurance claims, track accounts receivable, follow up on unpaid claims, and process client payments. They should monitor claim denial rates, understand why claims are denied, and implement corrections to prevent future errors. Sometimes they will handle billing questions from clients, explain policies, and manage payment arrangements.
Documentation management, compliance and risk management: They ensure that clinical documentation and administrative records meet insurance requirements and regulatory requirements by conducting reviews and internal audits. They maintain regulatory compliance with HIPAA protocols, state licensing laws, and internal compliance policies.
Clinical credentialing and licensure tracking: They ensure all clinicians’ licenses are active and they are properly credentialed with insurance companies. This includes tracking each clinician’s licensure expiration dates and managing the credentialing process with each insurance company on behalf of the clinicians.

Interview questions to identify high-quality candidates

When looking for the right traits and someone who can meet the responsibilities of the role, these are some key questions to ask:

Tell me about a time when you had to deal with a client who was angry and walk me through how you handled it.
Give me an example of a time when you noticed a mistake that could have significant consequences. How did you catch it? How did you go about communicating it to others and resolving the issue?
How do you go about handling multiple deadlines and follow-ups at the same time to ensure nothing falls through the cracks?
Walk me through a time where a policy or process didn’t fit the situation. What did you do about it?
Tell me about the digital tools you're most familiar with and how you have used those to create repeatable processes.
Tell me about your knowledge of HIPAA and how you ensure confidential information is handled appropriately.
Why are you interested in working in a therapy practice?
What are the most important factors for a healthy team? Give me an example of a time you've been a part of a team like this.

What practice leaders can do next

As a leader and the hiring manager for a new admin, your hiring process needs to be clear, structured, and thoughtful to find that right admin person. Here are some things to keep in mind.

Define the role clearly. Based on the size and current state of your practice, you can lay out what you need from this role and write a prioritized list of responsibilities. Determine a competitive compensation package for the role. This can be turned into a job description and be used for training and onboarding with your new hire.
Create a scored rubric for the interview process that is based on the ideal candidate traits and their responsibilities. Each category (communication, organization, compliance knowledge, etc.) can be scored on a numbered rating or as excellent, good, acceptable, poor. This creates a more objective rating system, especially if you have multiple team members conducting interviews.
Include at least one other team member into the interview process. “You should always have two team members interview candidates,” Gannon explains. This helps to double-check impressions, ensure a more clear picture of the candidate, and make a better decision.
As part of the interview process, you can use a paid working session or some test scenarios to get a better sense of the candidate's skills. This could include giving them some documentation with errors to see if they can find them, having them review the intake flow for a client who wants to use insurance, or asking them to walk you through a sample schedule and how they'd manage client requests and clinicians’ schedules with it. If you plan to use this method, according to HR for Health, you want to pay the candidate for their time to protect against liability.
Follow through with their references. They can provide helpful information for the hiring decision. You can ask very specific questions about topics such as reliability, systems thinking, and multitasking to make sure that you get the most useful information from the references.
Once you have hired the right person, you’ll want to make sure they have a smooth onboarding experience. Create a checklist that includes trainings, meeting the team, orientation to existing tools and policies, technology setup, and shadowing other team members. You can establish some 30, 60, and 90 day milestones to give them an early sense of accomplishment, following up on these with weekly check-ins.

Expand your practice with Headway

As you scale, Headway’s tools and team support can help you focus on your group practice’s growth instead of getting lost in the logistics. Headway is a practice management software that makes the job of every practice owner and their admin much lighter by helping with core administrative responsibilities. We provide tools for credentialing, billing, and documentation management, giving your admin a centralized view of the entire practice. As you grow, the same systems work for each new clinician and client you bring on. Reach out to a practice consultant today to learn how Headway can help make this a reality.

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This content is for general informational and educational purposes only and does not constitute clinical, legal, financial, or professional advice. All decisions should be made at the discretion of the individual or organization, in consultation with qualified clinical, legal, or other appropriate professionals.

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