Treatment Analyst

Welcome to Piedmont Cancer Institute — where patient care is more than a mission; it's a partnership and our values lead the way. For more than 38 years, Piedmont Cancer Institute (PCI) has proudly served the Metro Atlanta community, delivering exceptional cancer care built on a foundation of Compassion, Innovation, Communication, and Integrity. Today, our team includes 17 dedicated physicians, 20 skilled Advanced Practice Providers, across six locations (and growing) — all united in our commitment to excellence. At PCI, we blend cutting-edge treatments with deep clinical expertise and genuine compassion to offer truly comprehensive care. Our dedication goes beyond medicine—it’s reflected in how we care for our patients, support their families, and collaborate with one another. No matter your position, a career at PCI offers more than a paycheck. It’s a place where purpose meets passion, where connection fuels collaboration, and where your work makes a lasting impact. Why Join PCI? We're looking for talented individuals who share our passion for making a difference. If you value Compassion, embrace Innovation, prioritize open Communication, and act with Integrity, you'll thrive at Piedmont Cancer Institute—where every role plays a part in advancing hope and healing in our community. Here, you'll find purpose in your work. Job Description The Treatment Analyst representative works with insurance companies to authorize various treatment services including chemotherapy, infusions, and injectables. The Treatment Analyst demonstrates a high level of accountability to ensure accurate selection of insurance, documentation of benefits coverage, and submission of necessary preauthorization to ensure no delay in reimbursement of treatment. The successful candidate will be flexible and be able to multi-task in a fast-paced, high-volume setting. Our ideal candidate has a fundamental understanding of how insurance verification and precertification impacts the revenue cycle as well as PCI patients. Previous insurance verification and prior authorization experience is crucial for success in this role, experience in oncology preferred. This position is located at our Central Business Office in Atlanta and reports to the Treatment Analyst Supervisor. Primary Job Function Contacts insurance companies to determine preauthorization requirements for all chemotherapy, injectables, infusions or other treatments - including OPI treatment. Reviews and submits clinical information to support medical necessity for treatment, verifying the completeness and accuracy of all information before submission. Calls insurance companies or uses online tools to obtain preauthorization prior to service date. Follows-up timely and thoroughly. Utilize reports to initiate preauthorization on treatment and ensure authorization is in place at least 48 hours prior to the scheduled treatment. Ensures authorization details for all treatment services are documented in the patient’s record and within the Business Office link of OncoEMR. Review chemotherapy/treatment regimens in accordance to reimbursement and medical necessity guidelines. Provides feedback to IVR/Treatment Analysis supervisor regarding documentation issues and payer issues with non-covered chemotherapy drugs. Coordinate with clinic staff to inform them of any restrictions or special requirements regarding specific insurance plans. Coordinate with front office staff and IVR to ensure accurate insurance information is submitted and verified before all treatments. Confirm that verification details for all treatment is documented in the patient’s record. Acts as liaison between clinical staff, patients, IVR and insurance by informing all parties of coverage or precertification issues, including answering questions, helping, and relaying messages pertaining to verification and precertification. Has and maintains an advanced knowledge of authorization requirements for all payers including State and Federal regulations for coverage and authorization. Multi-task and use time efficiently; perform professionally at a high level under tight deadlines and in a fast paced ever-evolving work environment, successfully prioritize, and adapt to changing demands. Identify problems or trending issues, provide suggestions for findings, and to determine solutions. Communicate issues to management, including payer, system or escalated account issues. Respond timely to emails and telephone messages as appropriate. Regularly meet with IVR/Treatment Analysis Supervisor to discuss and resolve verification issues or preauthorization obstacles. Regularly attend weekly/monthly department meetings. Regularly attend monthly Revenue Cycle Department meetings. Other duties as assigned. Abide by Health Insurance Portability and Accountability Act (HIPAA) when handling any and all protected health information (PHI). Qualifications High school diploma (or equivalent) is required. Collegiate education preferred. Three + years of medical office experience is preferred with demonstrated skills in problem solving, attention to detail, ability to learn and use multiple systems and effective written and verbal communication skills. Advanced technical skills including PC and MS Outlook. Advanced knowledge of health insurance benefits including copay, deductible, co-insurance for In-network & out-of-network services. Advanced Knowledge of Precertification including infusion, injectables and other forms of chemotherapy. Advanced knowledge of CPT, HCPCs, and ICD-10 codes. Advanced knowledge of medical terminology and business office processes. Hematology/Oncology experience strongly preferred, however, not required. Strong interpersonal skills. Customer service experience and the ability to prioritize, work accurately, work well independently and able to maintain focus under pressure. Must be able to sit 8 hours/day and work through occasional high stress situations. Exposed to general indoor working conditions. Piedmont Cancer Institute is an Equal Opportunity Employer. Job Type: Full-time Pay: From $26.00 per hour Benefits 401(k) Dental insurance Employee assistance program Employee discount Health insurance Life insurance Paid time off Referral program Vision insurance Medical Specialty Hematology Oncology Work Location: In person HIPAA Requirements Treatment Analysis will have access to PHI and ePHI in the course of his/her duties. Applying the minimum necessary standard of HIPAA, this employee has access to the minimum amount of designated record sets required to perform his or her duties. #J-18808-Ljbffr PIEDMONT CANCER INSTITUTE