Quality Assurance - Health Insurance

Req Id: 106824

City: Tampa

State/Province: Florida

Posting Start Date: 10/31/25

Wipro Limited (NYSE: WIT, BSE: 507685, NSE: WIPRO) is a leading technology services and consulting company focused on building innovative solutions that address clients' most complex digital transformation needs. Leveraging our holistic portfolio of capabilities in consulting, design, engineering, and operations, we help clients realize their boldest ambitions and build future-ready, sustainable businesses. With over 230,000 employees and business partners across 65 countries, we deliver on the promise of helping our customers, colleagues, and communities thrive in an ever-changing world. For additional information, visit us at www.wipro.com.

Job Description:

Job Description

Position Summary

Quality Analyst for Evaluation & Management (E/M) for post pay medical coding who will be responsible for conducting quality reviews, ensuring compliance with CMS and payer-specific guidelines, and driving accuracy in post pay coding operations. The Quality Analyst will serve as a key resource for coding audits, error analysis, coder feedback and supporting revenue integrity initiatives.

• • Key Responsibilities
    
    • Perform quality audits on post pay E/M coding assignments to ensure accuracy, completeness, and compliance with CMS and payer-specific regulations.
    • Review coded medical records for adherence to ICD-10-CM, CPT®, and HCPCS Level II guidelines.
    • Validate coding against 1995/1997 and 2021 AMA/CMS E/M documentation guidelines.
    • Identify coding errors, trends, and training needs, and provide actionable feedback to coders.
    • Collaborate with Team Leads, trainers, and compliance teams to improve coding performance.
    • Support audit responses, compliance reviews, and risk adjustment initiatives.
    • Track and report error rates, productivity metrics, and quality trends.
    • Maintain updated knowledge of coding guidelines, payer policies, and industry best practices.
    • Ensure strict adherence to HIPAA and data confidentiality standards.

Required Qualifications

• Bachelor's degree in Life Sciences, Nursing, paramedic or a related healthcare field
• Minimum 3-5 years of medical coding experience with strong knowledge of Evaluation & Management services.
• Certified Professional Coder (CPC) or Certified Evaluation & Management Coder (CEMC) or Certified Coding Specialist (CCS) or equivalent credential required.
• Demonstrated experience in coding audits, quality review, or compliance checks.
• Strong understanding of ICD-10-CM, CPT®, HCPCS Level II coding, and E/M documentation guidelines.
• Familiarity with CMS, payer-specific rules, and 2021 E/M updates.
• Proficiency in EMR/EHR and coding software systems.
• Excellent analytical, communication, and documentation skills.

Preferred Qualifications

• Prior experience as a coding auditor, quality reviewer, or compliance analyst in E/M coding and exposure to post pay payer audit processes will be an advantage.
• Ability to design and deliver coder feedback or micro-trainings based on audit findings will be preferred.

Mandatory Skills: Claims_Processing .

Experience: 3-5 Years .

The expected compensation for this role ranges from $75,000 to $85,000 .

Final compensation will depend on various factors, including your geographical location, minimum wage obligations, skills, and relevant experience. Based on the position, the role is also eligible for Wipro's standard benefits including a full range of medical and dental benefits options, disability insurance, paid time off (inclusive of sick leave), other paid and unpaid leave options.

Applicants are advised that employment in some roles may be conditioned on successful completion of a post-offer drug screening, subject to applicable state law.

Wipro provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws. Applications from veterans and people with disabilities are explicitly welcome.

Reinvent your world. We are building a modern Wipro. We are an end-to-end digital transformation partner with the boldest ambitions. To realize them, we need people inspired by reinvention. Of yourself, your career, and your skills. We want to see the constant evolution of our business and our industry. It has always been in our DNA - as the world around us changes, so do we. Join a business powered by purpose and a place that empowers you to design your own reinvention.

Client-provided location(s): Tampa, FL

Job ID: Wipro-106824

Employment Type: OTHER

Posted: 2025-11-01T18:41:39