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Wipro

Quality Assurance - Health Insurance

Wipro, Tampa, Florida, us, 33646

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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

Bachelors degree in Life Sciences, Nursing, paramedic, or a related healthcare field. Minimum 35 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.

Compensation and Benefits

Experience: 35 years. Salary range: $75,000 to $85,000. Benefits include medical and dental benefits, disability insurance, paid time off (including sick leave), and 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. Join a business powered by purpose and a place that empowers you to design your own reinvention. Referrals increase your chances of interviewing at Wipro by 2x. Get notified about new Quality Assurance Specialist jobs in

Tampa, FL . Seniority level

Entry level

Employment type

Full?time

Job function

Quality Assurance IT Services and IT Consulting

Additional Job Titles

Clinical Documentation Auditor and Educator Quality Program Specialist Hybrid (Tampa) Acceleration Center Healthcare Business Analyst Senior Associate Customers Ops Healthcare Life Science Veeva CRM Consultant

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