Title: Registered Nurse (RN) Charge Code Auditor Location: Raleigh United States Requisition Number: 269549 Regular or Temporary: Regular Location: Raleigh, NC, US, 27704 Personnel Area: DUKE REGIONAL HOSPITAL Job Description: At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together. About Duke Regional Hospital Pursue your passion for caring with Duke Regional Hospital in Durham, North Carolina. With 388 beds it is the second largest of Duke Health's four hospitals and offers a comprehensive range ofmedical, surgical, and diagnostic services, including orthopedics, weight-loss surgery, women's services, and heart and vascular services. Duke Nursing Highlights: - Duke University Health System is designated as a Magnet organization - Nurses from each hospital are consistently recognized each year as North Carolina's Great 100 Nurses. - Duke University Health System was awarded the American Board of Nursing Specialties Award for Nursing Certification Advocacy for being strong advocates of specialty nursing certification. - Duke University Health System has 6000 + registered nurses - Quality of Life: Living in the Triangle! - Relocation Assistance (based on eligibility) General Description of the Job Class This position provides support to the Duke Health Lake Norman Emergency Department. Responsible for reviewing and verifying ED 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. Hours: This is remote with occasional onsite/office days. Workdays and hours are flexible: Monday-Friday 7-3, or 4 ten-hour shifts 7-5. Duties and Responsibilities of this Level Conduct a daily and thorough review of emergency department records and related documentation to ensure that all services provided during the encounter are accurately documented and billed. Communicate directly with ED staff to request necessary corrections to documentation to ensure accurate charging and billing. Communicate charge capture issues to the appropriate department manager. Provide ongoing staff education to improve charge capture and documentation. Track and collect data on corrected charges, monitor chargeable items, and complete required documentation to establish appropriate charge codes. Enter appropriate patient charge codes into Epic module. Provide support to the 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 ED billing accuracy, compliance, and revenue capture. Protect the security of medical records to maintain confidentiality. Perform other related duties incidental to the work described herein. Required Qualifications at this Level Education BSN Required Experience Three years of ED nursing experience is required. Experience with charge-capture entry in the EPIC/Maestro EHR strongly preferred. Prior nursing experience within an Operating Room or Oncology Clinic a plus. Familiarity with the Microsoft suite, including Excel, PowerPoint, and Word, is 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 the scope of the registered nurse. Knowledge of and appropriate application of the nursing process. Knowledge of theory, practice, and procedures. Ability to assess nursing documentation for accuracy. Knowledge of supplies required for ED procedures. Able to independently seek out resources and work collaboratively. Ability to establish and maintain effective working relationships. Proficient use of a computer and the ability to learn new software programs. Able to remain focused and organized. Ability to multitask. Working knowledge and completion of appropriate JCAHO and other regulatory requirements. Distinguishing Characteristics of this Level The Charge Code Auditor is a representative of the Medical Auditing Department. The position directly impacts revenue capture and requires working collaboratively and independently to meet deadlines. The intent of this job description is to provide a representative and level of the types of duties and responsibilities that will be required of positions given this title and shall not be construed as a declaration of the total of the specific duties and responsibilities of any particular position. Employees may be directed to perform job-related tasks beyond those specifically described in this description. Duke University is an Affirmative Action/Equal Opportunity Employer committed to providing employment opportunities without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex, sexual orientation, or veteran status. Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas-an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values. Essential Physical Job Functions Certain jobs at Duke University and Duke University Health System may include essential job functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department. Duke is an Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex (including pregnancy and pregnancy related conditions), sexual orientation or military status. Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas-an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values. Essential Physical Job Functions: Certain jobs at Duke University and Duke University Health System may include essential job functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department. Nearest Major Market: Durham Nearest Secondary Market: Raleigh

• Performs audits of medical record documentation to determine the accuracy of principal and secondary diagnosis (including MCC & CC) and procedure codes. • Adheres to official coding guidelines, coding clinics and regulatory guidelines and mandates. • Draws on advanced ICD-10 coding expertise to substantiate conclusions. • Utilizes proprietary auditing systems with a high level of proficiency to document audit determinations and rationale. • Consistently achieves productivity and quality performance standards established by management. • Actively cross-trains to perform reviews of multiple claim types to provide a flexible workforce to meet client needs • Assists management with training new Coding Auditors to include daily monitoring, mentoring, feedback and education. • Maintains current knowledge of coding guidelines and successfully completes required CEUs to maintain coding certification. • Responsible for attending training and scheduled meetings to enhance skills and working knowledge of clinical policies, procedures, rules, and regulations.

• Performs clinical quality assurance review of daily clinical validation reviews • Responsible for communicating with the initial auditor on differing decisions • Integrates healthcare auditing principles and uses objectivity in performance of medical audit activities and review • Utilizes industry knowledge and proficiency in healthcare to substantiate decisions • Performs work independently and reviews work of others • Reviews medical records and applies in-depth knowledge of clinical criteria to determine medical necessity

• Audits claims for coding accuracy, benefit payment, contract interpretation, and compliance with policies and procedures • Gathers findings at a macro level and makes recommendations for process improvement and efficiencies • Performs professional responsibilities with direct supervision on method and processes • Performs other duties assigned