Charge Code Auditor - Duke Raleigh Campus

Charge Code Auditor - Duke Raleigh Campus

This position provides support to Duke Raleigh Hospital (DRAH) Perioperative Services. Responsible for reviewing and verifying both surgical and medical charges within Epic to ensure accuracy and compliance with regulatory standards for the healthcare services provided. Also responsible for identifying discrepancies within hospital charges and nursing documentation in addition to communicating these findings to the relevant department for resolution and process improvement.

Duties and Responsibilities of this Level

• Daily reconciliation of charge sheets received from Operating Room (OR) and Endoscopy suite.
• Thoroughly review surgical records, anesthesia records, and related documentation to ensure that all services provided during procedure are accurately documented and billed.
• Communicate directly with Periop staff for needed documentation corrections to foster accurate charging and billing.
• Communicate charge capture issues to the appropriate department manager.
• Provide ongoing education for staff to improve charge capture and documentation.
• Track charges for supply items under miscellaneous codes and complete paperwork to establish specific charge codes.
• Enter appropriate patient charge codes into Epic OpTime module.
• Educate and orient staff to the charging practices and documentation standards for the department.
• Provide support to Patient Revenue Management Organization (PRMO) to assist with billing issues and patient inquiries.
• Maintain an understanding of medical record practices, standards, and regulations.
• Contribute to the development and implementation of policies and procedures aimed at enhancing OR billing accuracy, compliance, and revenue capture.
• Protect the security of medical records to ensure that confidentiality is maintained.
• Perform other related duties incidental to the work described herein.

Required Qualifications at this Level

Education

BSN Required

Experience

• Three (3) years of OR nursing experience is required.
• Experience with charge capture entry into the EPIC/Maestro EHR strongly preferred.
• Prior nursing experience within an Emergency Department or Oncology Clinic a plus.
• Familiarity with Microsoft suite including Excel, PowerPoint, and Word strongly preferred.

Degrees, Licensure, and/or Certification

Current or compact RN licensure in the state of North Carolina required. BLS required.

Knowledge, Skills, and Abilities

• Knowledge of scope of the registered nurse and surgical technologist.
• Knowledge of and appropriate application of nursing process.
• Knowledge of theory, practice, and procedures.
• Ability to assess nursing documentation for accuracy.
• Knowledge of supplies required for various surgical procedures.
• Able to independently seek out resources and work collaboratively.
• Ability to establish and maintain effective working relationships.
• Proficient use of a computer and ability to learn new software programs.
• Able to remain focused and organized.
• Ability to multitask.
• Working knowledge and completion of appropriated JCAHO and other regulatory requirements.

Distinguishing Characteristics of this Level

The Charge Code Auditor is a representative of the Medical Auditing Department. Position directly impacts revenue capture and must work collaboratively and independently to meet deadlines.