Teams at SmartLight Analytics

Perform detailed audits of hospital/facility claims and itemized UB‑04 bills to detect billing errors, DRG miscoding, and overpayments on high‑cost claims. Advocate for ASO clients by preparing documentation, negotiating with TPAs/carriers, coordinating stop‑loss reporting, and tracking recoveries. Analyze large claims datasets, build client reports, and partner with analytics teams to refine claim‑flagging and maximize recoveries.

Lead design and implementation of Snowflake-based data warehouse and ETL/reverse-ETL pipelines, migrate legacy SQL Server systems to cloud, secure sensitive healthcare data, mentor engineers, monitor pipeline health, and adopt dbt and Sigma for transformations and reporting.

Lead clinical reviews of facility and provider claims, ensure coding/billing accuracy and NCCI compliance, analyze clinical and claims data, manage Clinical Analysts, support carrier communications, refine workflows, develop dashboards/reports, and collaborate cross-functionally to improve payment integrity, quality, and operational efficiency.