177 - Exploring the Evolution of Remote Work and Talent Acquisition with Rivet's Ted Ferrin

Welcome to Listening with Leaders. I'm Doug Noll, lawyer turned peacemaker. I teach executive leaders how to listen to emotions rather than words so that they can become the leaders everyone wants to follow. And I teach those same leaders how to be authentically present, available, and connected to their families despite being insanely busy. I have learned that we are 98% emotional and and only 2% rational. Learning how to listen to emotions is, in my experience, the foundational skill of life. Stick around to the end of the show, and I'll reveal how you can be on our next guest in 15 to 20 minutes. So let's get started. Welcome to Listening with Leaders.

You are the co-founder and CEO of Rivet Health, found at rivethelp.com. And we're here to hear your story today. Thanks for taking your time out to be with me.

Hey, my pleasure. Thank you for having me.

So I interviewed you on Authority Magazine and what I thought was really interesting is that you had made a conscious decision to get into software as a service tech pretty much from the beginning. So tell us a little bit about that story.

Yeah, so I guess I stumbled into the initial software experience but then I very deliberately stayed in it forever and, and plan to forever. But I was a junior in college, needed a job, got married young, classic, you know, poor college student. And I saw a flyer on the wall that was like, how would you like to work with Harvard and Yale and Apple and Microsoft? And I thought, like, you know, I'd inquire about the job. That sounded more interesting than being like an on-campus, you know, intramural sports ref or something. And I went and, you know, yada, yada, yada, ended up getting a job at a company called Qualtrics. It's— I don't know if household name is being a little bit too generous to them, but at the time it wasn't super well known. But now fast forward, they're a publicly traded company. They're worth, you know, $15 billion or something like that. Their owner owns the Utah Jazz and they're like the preferred go-to software solution for doing market research. So just by total happenstance, I stumbled into software. I was in Utah at the time. Utah didn't have a huge tech scene and, but I just, I just loved it. I loved selling customers, earning customers, keeping customers. I'm not an engineer, but I definitely, you know, I have a romantic perspective on building products and how magical it is that software even works. And I just got deeper and deeper, you know, into it. So that was kind of my, my foray. And then I pretty much knew then that unless something big changes, I want to work in software. In tech in general, you know, for the rest of my career.

So tell us about Rivet. I know while you were at Qualtrics, you were thinking about starting your own software company and what was the evolution that got you started? Yeah.

So I worked at Qualtrics and a couple of other technology companies, one called Instructure in the education space. I worked for one called Canopy in the tax and accounting world. And so I had worked in vertical software, you know, vertical SaaS a lot. I had worked in several different industries. I'd never actually worked in healthcare, but again, was just getting a lot of experience. I was having a lot of fun building kind of this foundation of my own career. And then somewhere along the way, I started chatting with my co-founder, uh, Andrew Harding. Andrew and I, uh, played lacrosse in college together. We remained good friends since. He went into revenue cycle management consulting the entire time that I went into, you know, tech, um, and kind of startup land. And so We don't still to this day totally remember like the exact day or moment why we started talking about the intersection of our two careers, but we started talking about the intersection of technology and RevCycle. And of course, I come from a background that thinks tech can make everything better. And he comes from a background that knows a lot about the inner workings of how money moves hands in healthcare, which is very, very complex, as we've all experienced from the patient perspective. And we came up with a few ideas that we thought would move the needle and benefit provider organizations, which is who we wanted to serve. And yada, yada, yada. Fast forward, you know, almost we're now, we've graduated beyond our 6-year anniversary as a company and charging hard at 7. So here we are.

So Rivet, tell us what services Rivet provides. It sells the healthcare AR acceleration platform. That's a tagline.

Yeah, doesn't that tell you everything you need to know, Doug?

Absolutely. Yeah.

So, you know, I always say Rivet is very inside baseball subject matter. You know, everyone knows healthcare, everyone's experienced healthcare as a patient, everyone knows it's frustrating and kind of, I don't know, confusing and kind of feels like this black box from a financial perspective. But like, it's hard to describe what we actually do unless you really get into the weeds. Long story short, we do, we do a few things. One, like a pillar of the company is price transparency. So we have a tool that providers use to tell their patients what their out-of-pocket costs are going to be for a surgery, a routine visit, you know, or anything, you know, sort of in between. That's, that's probably the easiest product to relate with for the, you know, the common person out there who might not be deeply inside of healthcare. For those that, um, for, for our other products, they all deal with like the guts of the reimbursement, uh, process. Um, the reimbursement process meaning I'm a patient, I go to the doctor, doctor treats me and then bills insurance. They bill my particular insurance, obviously, and the insurance pays for some or all of that bill, and then I'm kind of left dealing with the rest. Um, that's called the revenue cycle. There's a lot of parts of it. There's like early registration, scheduling, check-in, pre, you know, pre, pre-service estimate. Um, there's like kind of mid-cycle where the claim is being sent to insurance, you're scrubbing it, there's a, a million intricate points. Um, and then there's kind of this back end of like denied claims and problem claims and cleaning up the, cleaning up the trash. So we have 3 really cool products that help add value in that process. One of them forecasts net revenue. One of them audits complex payer contracts, and one of them helps you work these problematic denied claims. So I'll leave it at that for now. Always happy to elaborate.

I'm a pretty smart guy, but it sounds pretty complex.

Yeah, it's a lot. Healthcare. And it's more than just Rivet. Like, turns out healthcare is a bear. There's a lot going on.

Yeah. So your customers are providers. That'd be the physicians and physician offices and practices?

Exactly.

Yep.

The offices, the practices, even hospitals. So it doesn't matter how big or small you are. If you provide healthcare services and bill insurance, there's a good chance Rivet is a good fit for you. So we typically don't serve dental, we typically don't serve like a medical spa for, you know, plastic surgery or cosmetic, you know, things like that. So it's typically if you're billing insurance, so orthopedics, ophthalmology, oncology, hospitals, multi-specialty ambulatory surgery centers. So the people in the trenches trying to help us, you know, be healthy and take care of ourselves where insurance is a factor. That's, that's typically who we serve.

And, and you started this up with your co-founder.

Yep.

Just 2 of you.

There and a 3rd co-founder, Paul Draper, who was our CTO.

And today, what, you have almost 100 employees?

Yep.

In 7 years. That's pretty amazing.

Yeah. Well, 6 years and 2 months. Let's round, let's round down on the, you know, that way we sound more impressive, Doug.

Okay. 6 years and 2 months.

Yeah.

That's a pretty remarkable journey. How did, how have you, tell us a little bit about the journey of starting the company and growing it and what kind of problems you saw and how do you, how do you, how do you engage in the problem solving process?

Yeah. Yeah. So Rivet, when we, when we, you know, founded Rivet, kind of did the classic quit your jobs, everyone plan on not making any money for 12 months. That, that was how we did it. And we, in our unique situation, each of us kind of had, you know, personal financial runway to afford the risk and, you know, willing willingness to, to take on the risk. And that was our plan. But we ended up raising venture capital about 5 months in. So we started in January 2018. We closed a seed round in May of 2018. Lux Capital, who's based kind of bicoastal, they're based in San Francisco as well as New York City. They led our seed round and Pelion Venture Partners in Utah participated and kind of filled out the round. So we feel really fortunate that we ran into some folks that are very smart and saw the problems that we saw and think healthcare billing should work a lot better than it does. So they were willing to back us from very, you know, very early on and have continued to be great investors since. So that's, you know, from a logistical perspective, how we, I guess, really got started. Obviously, we were 3 people working on the product early on, but But that, that helped us grow from, you know, a team of 3 people to a team of more like 8 to 10, you know, fairly, fairly early in our life that allowed us to kind of get after it a little bit more aggressively building this complex software and, and elegant solutions to, to tricky issues. And then obviously we, you know, turns out attracting customers and growing and the real stuff matters more. And the, you know, we started to do that, started to do that pretty well. And the rest is history, at least, at least up until now.

And your customer base all over the place?

All over the place. We have customers in 48 states. We are missing Vermont and Hawaii. So I'll fly to Hawaii and take care of that. If anyone else can volunteer to help us get in, help us get in Vermont. But yeah, we have customers in 48 states. We have customers that are tiny, 1-doc, 2-doc practices. We have customers that are gigantic. The biggest ambulatory services provider in the country is a customer of Rivet.

Wow.

Tens of millions of claims a year. And then we've got everywhere in between. And again, both, both sizes as well as like specialties, facility types. So there's a big difference between a, you know, family physician, you know, kind of family, family medicine office and an orthopedic surgeon and a hospital or, you know, an ASC or something. And we heard them all. So it's been, it's been, been a really fun variety.

Um, what's your revenue model?

Um, 99.9% recurring revenue based on software contracts. Um, we, we make a little bit of money off of payment processing, but that's less of the core business model and more of just like a— it's a little bit of tip money, uh, based on a cool feature that we have in the product that, that a handful of our customers really love. But for the most part, we just, we just do good old software as a service recurring revenue contracts.

So it's basically subscription-based. Mm-hmm.

Yep.

Wow.

So now you've been doing this for 6 years and, and 2 months. You, you, you've been at it for a while. What is it that gets you excited and up in the morning you go to work?

Yeah, I mean, the first one is, is our team. Like, I love our team. I, we, as, as acknowledged, we work in some very complex and very, very challenging subject matter and it's hard. But I, I am very inspired on the regular by how much our team not only tolerates that, but actually loves that. Like they love hard, you know, like especially, you know, our engineers and really everyone kind of throughout Rivet, but they tackle hard problems and they love it, you know, and they find so much fulfillment in it. And so I love to apply what I'm good at to solving hard problems. And, you know, I've been very inspired working alongside people that love to apply what they're good at. In solving hard problems. And, you know, it's come together to make Rivet what it is. And then second to that is certainly customers. Like, I think there is something special and romantic, and it's probably the reason I'm in the career path that I'm in, about like creating something that didn't exist and it getting so good that people will pay you money for it. And in many cases, a lot of money for it. And I just think that's really cool. But it's even cooler when they renew, you know, a year later and then again 2 years later and then again 3 years later and then again 4 years later. So very, very inspired to like have that crazy thing that happens when people will actually pay us for something that didn't exist 5 years ago and then keep paying for it once they, once they see that it's actually like benefiting their organization and making them you know, making them far stronger. So those are the two main things that really get me going. And then I'm also a competitive guy and I like, you know, setting goals and tackling them and chasing after them. So that of course is a nice side dish.

What is it that you think is unique about you that you bring to the table that's made Rivet successful? You were just talking a moment ago about some of your skill sets. What do you think those are?

Well, I, so I grew up through kind of a sales background, customer-facing background, and I think that has definitely helped us to raise money and to, and to get a lot of our first customers and even, even still this to this day, like 2, 2 or 3 meetings I had today, I was on the phone with either existing customers or potential new customers. And I, even though I'm, you know, the CEO of a 90-person company, not that that's huge, I still spend a ton of time directly, like directly interfacing on Zooms or in industry conferences directly with customers. And so That is, that's probably the main way that I help growth directly. Hopefully I facilitate a lot of good things, you know, culturally and as far as goal setting and strategy and direction in my, in my day job, so to speak, as the CEO. But, but when I, when I get to put on that sales hat or that customer success hat and just really, you know, dive in, you know, up to my elbows in the fun stuff with you know, with the team directly with customers. I think that's probably where I shine the most. So yeah, I think maybe some attributes like I am competitive. I played sports in college, very goal-oriented person. I like to think I'm gritty. So I think those are those kind of back up the, the customer-facing inclination that I have.

And you get to ski Snowbird every weekend.

And I get to ski every weekend because we're headquartered in Salt Lake City, Utah. So how could I not be happy, Doug?

Good for you.

Yeah, this show is called Listening with Leaders, and I don't know how much you've studied my background, but, you know, I was a lawyer for a long time and then went back to school, got my master's degree and became a mediator and a peacemaker. And today I teach people deep listening skills. And I'm just curious, I like to always ask my guests about the role of listening in the growth and success of, in your case, Rivet.

Yeah, well, I should be one of your subjects that studies at your feet, Doug, because I'm great at talking and I'm learning to get good at listening. But, but it's, it's funny you bring it up because I, I couldn't like plus one enough the importance of listening. I've learned a lot of lessons, you know, the hard way and the easy way, just in terms of becoming a better listener over the course of building Rivet. Obviously before that as well. But, um, you know, Rivet is not one person trying to build great products and take them to a big industry. Today it's 90 people, and those 90 people need to work well together. They all have opinions, uh, some are great opinions and some are not great opinions, and I have great opinions and some not great opinions. And through all that, like, we have to listen to each other, and you have to decide what to do with that information even once you listen, you know, to somebody. And, um, yeah, there's just been a, you know, countless number of lessons on, like, the importance of listening first and talking second. And I'm still working on it, but I, you know, I feel like we've had success because culturally I think all of us really try and listen first, talk second, even if some of us like to talk more than others. I think we still like to emphasize the importance of listening first and talking second. And even if you do feel the need to talk first and you're well studied on a certain topic, you might then walk into a meeting where someone else is well studied or well thought on a particular topic or a decision we need to make. And all of a sudden you need to, I think, put that listening mode, you know, fully engaged again because like the things that you thought are now butting up against the things that someone else thought. And somewhere in there you got to figure out what the right, best answer is. And, you know, we've really tried to emphasize that like meritocracy wins at Rivet, not hierarchy. And so I think to, you know, to get there and figure out what does have the most merit, it just takes a lot of like let's take turns sharing points of view and diving into data and informing and trying to make the best decisions we can.

I'm just curious, as an aside, are you guys, are you guys all local, remote, or hybrid?

Well, kind of a hybrid approach. Yeah. So we've got about 90 employees. I'd say about a third of them are in the office any given day. And about 70% of the team is in Utah. So we, some of us see each other all the time. Others, see them once a year when we do like an annual get-together kind of retreat. And it's been interesting. I, before COVID I was not a fan of remote work. It would have never crossed my mind. I thought it was for slackers. I have— I wouldn't say I've done a 180. I still think there's a lot of value in meeting in person, but I have— I'm very open to remote work, partially because I think it actually forces your culture and your company to be a lot more deliberate in your communication. You can't lazily just like turn, speak, you know, and like have interactions happen all the time, some of which actually aren't productive. You have to be pretty deliberate about when you engage, why you engage. There's a lot more that's like scheduled and documented and a handful of things. So in certain ways, I like the discipline that remote work requires to do it well. In the spirit of documenting thoughts, documenting research, rooting a lot of, rooting a lot of your analysis in like real data instead of just like the most persuasive person who I think tends to do better in an in-person setting where it's, it's a, you know, more about showmanship than perhaps the, the substance behind something. So that those are some of the fruits of remote that I've really liked that benefit us even I think in our kind of full, you know, in-person every single day. Part of the company and operations of the company. So I, I really liked, you know, the, the, I don't know, the, the, the boost that has come from both and trying to find the, the happy medium for us.

That sounds really cool. I, I really like the way you describe it as being to do remote or hybrid culture right, you've gotta be much more disciplined than you might otherwise be. I don't think I've heard it expressed that way before, but it makes perfect sense to me. You gotta be really thoughtful about it.

Yeah, yeah. No, I think it— remote can end up having some people feel very isolated, unengaged, and honestly maybe not working that hard or maybe not that engaged. But if you, if you can thread the needle and have, I think, a lot of clarity in what's expected from everybody, how you work, when you work, how you make decisions, how we measure success, then I think remote can be this really productive superpower and allow you to tap into a really engaged workforce that's, you know, maybe broader than just one small geographic market.

So how do you set all that up? I mean, you covered that— what you just said covers a lot of territory, talking about your communication processes, your decision-making processes, how are you gathering data, how you're, how you're Managing to work together, either whether you're in an office or whether people are outside the office and coming in during Zoom. Did this stuff just evolve organically or is this something that you and your co-founders were very methodical about in terms of thinking how you're gonna develop this?

Yeah, I would attribute it more to the evolution than the, you know, my co-founders and I and like Rivet leadership team, have been deliberate about. I like to think it's, you know, both, obviously, to some extent. But keep in mind, when we founded Rivet, remote was not a prevalent way of working. It certainly wasn't one that we were out to popularize or prove or anything. And then COVID kind of forced us into it. And so there was big evolution point number one. Well, big, you know, big, I guess, initial, initial who Rivet was came in the first kind of 18 months of Rivet. And then I guess first 2 years of Rivet and then COVID hit and it forced evolution and it was painful on a couple of, you know, on a couple of points. But it was also really, I think, an opportunity to grow and like change how we did certain things. So like even, you know, the most popular internal chat tool is Slack. Like everybody's on it. We're on one called Twist. It emphasizes asynchronous work more. You can obviously chat like real time synchronously and we do very frequently. But just a few paradigms that are somewhat hard to explain make it a little bit easier to like organize the work and the follow-up and like what projects are ongoing and what conversations are ongoing. So I really like that tool. I think it's been really beneficial to like the approach to work that we've taken. We use Notion. So Notion is just a big kind of, I don't know, unstructured database that you can use in a million different ways, everything from a to-do list to project management to, you know, database stuff. Um, and we definitely have like, we like, I guess let me put it this way. Not only do we use those two systems, when you start at Rivet, there is a training on how to use them. Oh, it's not a training on like functionality. It's a training on how Rivet chooses to use these things. Um, everything from who you tag in a message, uh, because who you tag do need to reply and who you don't tag, good. It doesn't bother them and it, you know, doesn't have that little that little noise bothering you all day to interrupt when you're trying to, you know, deeply design something, engineer something, write something, build a model, you know, etc. So we're big fans of deep work. And I think we like the kind of asynchronous emphasis that remote work has helped instill into our culture, whether they're remote or not. So those two systems, I think, are probably the backbone. And then, of course, like, we use Google Meet internally, we use Zoom for external, you know, customer-facing meetings. But we hop on Google Meet, you know, meetings a lot. So even though I think remote and kind of asynchronous communication and discussion can be really effective, like as soon as you're in a debate or as soon as you're a little confused or as soon as like you hit a bit of a dead end, I think remote can be awful for you to stay, you know, lonely, stuck in that problem. And so that's where we try and quickly jump on Google Meets to resolve conflict or complexity or certain things where writing it out is just a waste of time. So I'd say those are the 3 like systems that kind of power how we do what we do. And we didn't always, we didn't always use them. In fact, when we founded Rivet, we didn't use any of those 3 like ever. And now, now not a day goes by that I'm not on all 3, you know, and relying on them.

So yeah, just another example of how COVID changed the world. My work, my work used to be all in person. I haven't done in-person work.

And well, it's a shame because we could be skiing right now.

Exactly. Yeah. You know, and I have gone skiing up at our local resort and taken my phone and done a Zoom meeting on it, shared, like talking to somebody.

Yeah.

I mean, we're, we can do that now. I've had, I've had mediations where I was a mediator and I had a lawyer in Paris. A lawyer in Boca Raton, Florida, a client in Toronto, another client in Temecula, California. Yeah, we couldn't have done that prior to COVID. It was— and now you can have those kinds of meetings. It's crazy.

Yeah, absolutely. Well, I mean, even today we onboarded 2 new employees to Rivet. One of them is here in Utah and another is out of state., and they both have very unique backgrounds for the position we were hiring for. I think it would have been hard to hire both of them in Utah. I wouldn't say we have a preference to Utah, but like if there's a, if there's a tie, I think we like the idea of people being close and being able to come to the office if they want to. But it was hard to find two qualified, you know, professionals for this particular position and having the luxury of tapping into someone who happened to live in Washington State. Is a game changer. You know, it's, it's really powerful. So we really liked the, you know, depth of talent pool when you start thinking of things nationally and then even obviously globally to the extent that your operations are global. Ours are not, probably won't be. Like we're pretty focused on the US healthcare system. So, but like even just being able to dip into talent nationwide is, has been an absolute boon to, I think, the, the quality of professionals that we have working at Rivet.

Wow, good. One more question, I'll let you go. What, um, what's one thing about yourself, Ted, that we wouldn't know about unless you revealed it to us?

That you wouldn't know about? Well, I don't want you to know about them, that's why I conceal them so well. So, um, I would say, um, the most hotly debated one at Rivet is that I frequently enjoy water with my cereal and not milk, and I, and I find it to be totally acceptable as long as the water is cold enough. So that's my playful one. How about that?

Wow.

On a more, on a more serious, like, how do I do what I do and it makes me who I am, I would say that, like, uh, so I, I got a nickname growing up from my friends called Competited. Um, I'm ex— I'm extremely competitive. But not— I've seen, I've seen competitive in two lights. One is like a horrible, like petty, can't be a gracious loser type of competitive. And then there's like people who love competition. They just like, it brings the best out of you. It brings the best out of anyone in it. And I like to win, don't get me wrong, but like, I like actually competing more than I like must win to like, I'm not out to, you know, prove I'm better than anybody all the time, but whatever. I just love sport. I love the idea of like when people come together and, and there's a purpose to the game and somebody emerges a victor. I just think that's fun, and it's fun to chase it. And if you lose, like, great, be a gracious loser and try and come back a stronger, you know, competitor in whatever it was. So I'd say it doesn't take too long, especially if we're anywhere near like a a, you know, a gym or a golf course or anything where, where I can, you know, challenge anyone to any dumb game that we invent on the fly. But, but I, I do feel like that helps me stay very motivated to just work hard, um, in, in, you know, these mini and big games of life, I guess, that we all spend our career on.

So, well, Ted, this has been a great conversation. Thank you so much for your time today.

Thank you, Doug. Appreciate it.

Doug Noll here. Thank you so much for listening to Listening with Leaders. If you are a successful executive leader who would like to be on this program, please visit podcast.dougnull.com/podcast. If you got something out of this interview, would you please share this episode on social media? Just do a quick screenshot with your phone and text it to a friend or post it on the socials. If you know someone that would be a great guest, tag them on the social media to let them know about the show and include the hashtag #ListeningWithLeaders. I love seeing your posts and guest suggestions. We are regularly putting out new episodes and content. To make sure you don't miss any episodes, go ahead and subscribe. Your thumbs up, ratings, and reviews go go a long way to help promote the show and mean a lot to me and my team. Want to know more? Go to my website, DougNoll.com, or follow me on LinkedIn, Facebook, and Instagram. That's @DouglasEnoll. Thanks for listening, and we'll see you on the next show.