Charge code auditor

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Pursue your passion for caring with Duke University Hospital in Durham, North Carolina, which is consistently ranked among the best in the United States. The largest of the four Duke Healthhospitals with 1062 patient beds, it features comprehensive diagnostic and therapeutic facilities, including a regional emergency/trauma center, an endo-surgery center, and more.

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Occ Summary

The Charge Code Auditor for the Birthing Center is responsible for ensuring accurate, complete, and timely charge capture for all hospital obstetric services, including OB Emergency Department (OB ED) visits, OB Operating Room procedures, vaginal and cesarean deliveries, newborn hearing screens, and circumcisions. This role audits nursing documentation and patient charges, identifies discrepancies, and collaborates with clinical and operational leaders to ensure compliance with billing standards and regulatory requirements. The position directly supports revenue integrity and accurate reimbursement for the Birthing Center.

Shift: Mon-Fri 8 hour shifts

• Work Performed
• Reconcile daily census and charges for all Birthing Center service areas, including OB ED, Labor & Delivery, OB OR, and Postpartum/Newborn Care.
• Review patient charts for completeness and verify that all services—OB ED evaluations, delivery charges, OB OR procedures, hearing screens, and circumcisions—are accurately documented and captured.
• Identify missing, incomplete, or incorrect charges and update charge sheets according to departmental and organizational standards.
• Communicate with nursing staff, providers, and ancillary teams to obtain required documentation for accurate billing.
• Escalate charging or documentation issues to the appropriate department manager or clinical leader.
• Provide ongoing education to Birthing Center staff regarding charge capture expectations, documentation standards, and updates to charge codes or workflows.
• Track supply item usage in the OB OR and ensure appropriate charge codes are created or updated when needed.
• Enter all applicable patient charge codes into the designated information systems, ensuring accuracy and timeliness.
• Serve as a resource to Billing, Patient Accounting, and insurance representatives to resolve billing questions, denials, or patient inquiries related to obstetric services.
• Maintain a working knowledge of medical record standards, regulatory requirements, and payer-specific billing rules related to obstetric and newborn care.
• Develop, maintain, and update written policies, procedures, and guidelines for charge capture within the Birthing Center.

• Knowledge, Skills, and Abilities
• Knowledge of the scope of practice for registered nurses in obstetric settings.
• Understanding of obstetric workflows, including OB ED triage, labor management, delivery processes, OB OR procedures, postpartum care, and newborn services.
• Ability to assess nursing documentation for accuracy, completeness, and compliance with billing requirements.
• Familiarity with supplies, equipment, and procedural steps associated with vaginal deliveries, cesarean sections, and OB OR cases.
• Ability to work independently, prioritize tasks, and meet deadlines in a fast‑paced clinical environment.
• Strong communication skills and the ability to collaborate effectively with nursing, providers, billing teams, and leadership.
• Proficiency with computer systems and willingness to learn new software platforms.
• Ability to remain focused, organized, and detail‑oriented during prolonged periods of chart review.
• Working knowledge of JCAHO and other regulatory requirements related to documentation and billing.

Level Characteristics

The Charge Code Auditor serves as a key representative of Birthing Center leadership in ensuring revenue integrity. This position directly impacts reimbursement and must work both collaboratively and independently to meet audit and billing deadlines.

Minimum Qualifications

Education

BSN Required

Experience: Three years of nursing experience is required

Degrees, licensures, certifications

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

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.

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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.