Patient Access Specialist – Differential Waiver, Prior Authorization

Sanford Health

Patient Access Specialist validating insurance eligibility and prior authorizations at Sanford Health. Responsible for ensuring proper documentation and communication with third-party payers and provider offices.

Posted 7/31/2026part-timeRemote • Minnesota, North Dakota, South Dakota • 🇺🇸 United StatesJuniorMid-Level💰 $17 - $27 per hourWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in insurance eligibility verification, prior authorization processes, and medical terminology. Proficient in communication with healthcare professionals and third-party payers to ensure accurate documentation and benefit coverage.

Highest-signal resume keywords

Insurance Eligibility VerificationPrior Authorization ProcessMedical TerminologyPatient Registration VerificationDocumentation Collection

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Insurance BackgroundCPT Code IdentificationBenefit Coverage ResearchMedical Necessity DocumentationProfessional Services Denial Review

Soft Skills

CommunicationCollaborationProblem-Solving

Tools & Technologies

Office EquipmentComputers

Industry Keywords

HealthcareHospital SettingClinic Setting

About the role

Key responsibilities & impact

Reviews and validates insurance eligibility, prior authorization and/or referral of medication, procedures, etc.
Collects necessary documentation and communicates with third party payers, healthcare professionals and customers to prioritize requests.
Verifies patient registration and confirms benefit coverage, including deductibles and out-of-pocket expenses; researches and verifies covered benefits for ordered tests, procedures, and other services.
Responsible for assuring that prior authorization for medical services is completed and confirmed.
Obtains diagnosis(es)/CPT code(s) from medical chart and/or provider office.
Contacts third party payer to determine appropriate prior authorization process.
Works closely with provider offices to obtain and clarify documentation to demonstrate medical necessity.
Reviews professional services denials; works with clinics and third party payers on appeal process.

Requirements

What you’ll need

High school diploma or equivalent preferred; post-secondary education helpful.
Minimum of two years of experience in a hospital or clinic setting required.
Understanding of medical terminology, insurance background, office equipment and computers is required.

Benefits

Comp & perks

Opportunity to work remote