Advanced analytics. Human expertise. Independent oversight.
Organizations deserve transparency, accountability, and a fiduciary advocate working in their best interests. SmartLight combines sophisticated AI models, advanced analytics, and objective human expertise to help clients make better decisions and achieve stronger financial outcomes.
We’re hiring SmartLighters.
Careers →Identifying a broad spectrum of cost drivers to remove wasteful spend
Ongoing monitoring
Continuous monitoring of medical, pharmacy, and dental claims to identify anomalies, validate findings, and uncover recovery opportunities.
Plan Design Evaluation
Evaluate plan design, summary plan descriptions, and plan edits to identify gaps, misconfigurations, and unnecessary healthcare spend.
Payment Integrity & Dispute Resolution
Validate shared savings calculations and advocate on clients’ behalf to resolve disputes, recover overpayments, and protect against improper payments.
Price Transparency Alignment
Compare contracted rates and market pricing to identify outliers and uncover opportunities to reduce unnecessary healthcare costs.
FAQs.
How is SmartLight different from carrier-offered FWA programs?
Carriers are contractually required to adjudicate claims correctly—but automation errors, aggregated data review, and random sample audits mean overpayments go unrecovered. High-
dollar claims may be missed or have significant payment errors. Low-dollar claims don’t get reviewed but add up to significant losses. “Shared savings” programs correct carriers’ own mistakes, extracting more fees from your plan.
SmartLight Analytics provides independent claims integrity oversight by monitoring 100% of medical, pharmacy, and dental claims — and advocates on your behalf to recover
overpayments.
Will our members be disrupted?
Member disruption is minimal to nonexistent. SmartLight identifies provider billing errors,
claims processing mistakes, and contract outliers. SmartLight will not ask for claim denials without thorough review, which typically involves medical records review.
How does SmartLight integrate with carrier processes?
During implementation, we conduct a kickoff call with the carriers to obtain historical data and an ongoing data feed process. As anomalies are identified, referrals are published to the carrier through our secure portal. Ongoing updates are published in real time until a decision is made.
If a carrier disagrees with our findings, SmartLight will review their rationale. Should the data not support their decision, SmartLight will consult with our client on further action, including possible Independent Dispute Resolution (IDR).
How does SmartLight secure our claims data?
SmartLight Analytics maintains a rigorous governance framework centered on data integrity and client trust. We complete annual independent audits through The Johnson Group, which includes our SOC 2 Type 2 attestations and HIPAA compliance verification—giving clients current, verified assurance regarding our controls for security and confidentiality, ensuring that all managed data is handled with the highest level of administrative and technical protection.
Are there really large amounts of fraud, waste, and abuse within my plan’s healthcare claims?
The National Health Care Anti-Fraud Association (NHCAA) estimates the losses due to healthcare fraud are in the tens of billions of dollars each year. Some experts place the total as high as 10% of the annual health outlay. Plan sponsors can find it difficult, if not impossible, to find fraud, waste, or abuse just by reviewing healthcare claims. Not only does the complex medical coding system make healthcare claims indecipherable to non-clinical reviewers, but these abuses can also be extremely hard to identify when unscrupulous providers are constantly finding new ways to beat the system. Wasteful spending and abuse remain undetected most of the time because carriers seldom have the resources to comb through all the data consistently. SmartLight combines expert investigative and clinical teams with an AI-powered analytics platform to uncover wasteful spend in your plan's healthcare data.
How involved do I need to be as the plan sponsor?
Our clients empower SmartLight to act as an advocate for them with their plan administrator. When our proprietary AI models identify anomalies in the data, flagged items are moved to clinical and investigative review. Our carrier engagement team works directly with your carriers’ claims administrators to refund overpaid dollars. Clients have real-time access to our reporting dashboard and can view specific claims referrals, including carrier responses.
Does SmartLight Analytics have private investigators to research suspected fraud?
SmartLight has licensed private investigators (License #24136801) who initiate research into
possible fraudulent providers. Private investigators are trained to probe deeper into suspected fraudulent activity based on established patterns gained through their experience in investigations. This licensure ensures that our clients benefit from the most rigorous research into suspicious claims — conducted with professional integrity at every step.
Meet the team.
Asha George
Chief Executive Officer & Co-FounderAsha George co-founded SmartLight Analytics and serves as Chief Executive Officer. With more than 20 years of experience in healthcare analytics, epidemiology, and biostatistics, she leads SmartLight’s mission to help organizations improve healthcare spending through advanced analytics, expert review, and independent advocacy.
Before founding SmartLight, Asha held leadership and consulting roles across the healthcare technology industry, including directing statistical analytics at Emdeon and leading data intelligence initiatives for HCSC. Under her leadership, SmartLight has become one of the fastest-growing private companies in America, earning recognition on the Inc. 5000 list. She holds a Master of Public Health in Biostatistics from the University of Texas Health Science Center at Houston.
Franklin Baumann, MD
Chief Medical Officer & Co-FounderDr. Franklin Baumann co-founded SmartLight Analytics and serves as Chief Medical Officer. His background as both a practicing surgeon and healthcare executive gives him a unique understanding of clinical care, claims integrity, and healthcare oversight.
Before SmartLight, Dr. Baumann held senior medical leadership roles at UnitedHealthcare and Emdeon, where he focused on utilization management, payment integrity, fraud prevention, and clinical oversight. His experience working on both the provider and payer sides of healthcare helps ensure SmartLight’s solutions are grounded in clinical expertise and real-world insight.
Julia Posacki
Chief Strategy OfficerJulia Posacki serves as Chief Strategy Officer, leading SmartLight's strategic growth, partnerships, and market development. Combining experience in healthcare technology and financial services, she helps employers better understand healthcare spending and improve decision-making through education and independent advocacy.
Prior to joining SmartLight, Julia spent nearly two decades advising organizations on capital strategy, risk management, and financial markets, beginning her career at Goldman Sachs. She holds a bachelor's and a master's degree in Engineering from Cornell University with a concentration in Finance.
Chintan Sutaria
Chief Operating OfficerChintan Sutaria serves as Chief Operating Officer, leading SmartLight’s operations, technology, and organizational growth. With more than 20 years of experience in operations, strategy, and technology, he focuses on building scalable systems that help SmartLight deliver exceptional results for clients.
Before joining SmartLight, Chintan founded and led CalcuQuote, growing it into a leading technology platform for the electronics manufacturing industry before successfully exiting the company. He holds a Bachelor of Science in Business Administration from the University of Southern California.
Joshua Luth
Chief Product OfficerJosh Luth serves as Chief Product Officer, leading SmartLight’s product strategy, technology platform, and innovation roadmap. As one of the company’s founding contributors, he helped build the analytical and engineering foundation that powers SmartLight’s healthcare claims integrity solutions today.
Josh brings extensive expertise in healthcare claims data, provider billing, network pricing, and claims systems, having worked with many of the nation’s leading carriers and third-party administrators. Prior to SmartLight, he held technology and product leadership roles at Benefitfocus and Baer & Timberlake. He earned a Bachelor of Science in Business Management from Oral Roberts University.
Rusty Wyrick
Chief Technology OfficerRusty Wyrick serves as Chief Technology Officer, leading SmartLight’s technology strategy, platform development, and innovation roadmap. With more than 18 years of experience in healthcare technology, he is focused on building scalable solutions that help organizations improve healthcare outcomes, reduce wasteful spending, and make smarter decisions through data and advanced analytics.
Throughout his career, Rusty has led software engineering, product development, analytics, and digital transformation initiatives across the healthcare industry. Prior to joining SmartLight, he held executive leadership roles including Product Owner for Analytics at Benefitfocus/Voya Financial, Chief Technology Officer at CareATC, and Chief Transformation Officer at CommunityCare Health Plan. He earned a Bachelor of Science in Business Administration and Management Information Systems from Oklahoma State University.
Let’s start a conversation.
If you’re ready to take greater control of your healthcare spend with an independent advocate in your corner, let’s talk.
Work with smart people on problems that matter.
Join a team of analysts, data scientists, engineers, clinicians, and advocates who challenge assumptions, share knowledge, and help organizations make smarter healthcare decisions every day.