Spotlight: Eliana Berger @ Joyful Health

A spotlight is a short-form interview with a leader in RCM or health tech.

In this spotlight, you'll hear from Eliana Berger, CEO at Joyful Health. You'll learn what Joyful Health does and how Eliana thinks RCM will change in the next few years.

What does Joyful Health do?

Joyful Health is a specialized revenue recovery service that focuses exclusively on the hardest part of the revenue cycle: following up on denied and unpaid claims. What makes us true experts in this space is that we hire people with payer-specific expertise who know exactly how to navigate each insurance company's systems, understand their unique resolution pathways, and can get things done quickly and accurately.

What makes us different:

• Performance-based pricing - We only get paid when we successfully recover revenue for you
  
  

• Cost optimization - As your clean claims rate improves, you pay us less, naturally optimizing your cost to collect
  
  

• Zero risk - No upfront costs, no minimum fees, services pay for themselves
  
  

• Seamless integration - We work entirely within your existing systems with no new software required
  
  

• Specialized focus - We handle denials and aged A/R recovery so your team can focus on scaling your core business

For fast-growing digital health companies, this means you can maintain lean operations while ensuring maximum revenue recovery from day one. We typically help practices recover revenue worth 5-10x our fees, making it a no-brainer investment that scales with your growth.

How did you end up working in health tech?

My path into health tech started at home. Growing up, I watched my mom and grandmother run an independent therapy practice, spending countless hours managing claims and constantly worrying about whether payments would come through. That experience stuck with me.

A few years ago, I became curious about what was really keeping independent practices on the brink of survival. So I started volunteering as a free consultant for several practices - helping with everything from ordering office furniture to analyzing their EHR data. What I discovered was eye-opening: practice owners had no idea where their money was.

Their financial data was scattered across multiple systems with no way to see the full picture. This led me to essentially become a fractional CFO for these practices, spending hours pulling together fragmented reports to give them clarity on their revenue. What I found was shocking - many were losing 10-30% of their revenue without even realizing it. The money was there, just trapped in denied claims and unpaid receivables.

That insight became the foundation for Joyful Health. We're building the modern financial operating system for healthcare, starting with revenue recovery. When you can finally see all that fragmented data in one place, it becomes crystal clear how much money is being left on the table - and more importantly, how to systematically recover what practices are rightfully owed.

How does your role intersect with revenue cycle management (RCM)?

As CEO, I'm constantly thinking about RCM from both a strategic and operational lens - but so is our entire team!

Everyone at Joyful, including operations, engineering, and beyond, regularly fights denied claims alongside our RCM specialists. This helps our entire team understand what the workflows actually look like, from interpreting denial codes to navigating payer portals to executing the right resolution actions. As a result, when our engineers are building features, they understand exactly what data points matter and how billers actually work. When our operations team is designing processes, they know the real bottlenecks and pain points. This deep, practical knowledge allows us to build products and services that are truly integrated within the systems and processes practices already have, rather than creating yet another tool that sits on the side.

From a strategic perspective, this operational depth helps me make better decisions about our product roadmap and service delivery. It's not enough to build cool technology - it has to directly solve real problems in the revenue cycle. And because everyone on our team has fought these battles firsthand, we can build solutions that actually work in the messy reality of healthcare billing.

What do you think RCM will look like two years from now?

I think we're heading toward a world where RCM becomes much more specialized and data-driven, with a clear separation between the "science" and "art" of revenue cycle management.

The "science" - rules-based, routine tasks like eligibility verification, claim scrubbing, and payment posting - will increasingly be handled by AI automation, which is already creating huge efficiencies. But the real breakthrough I'm excited about will be when AI starts getting better at the "art" side too: the complex human judgment required for things like denial management and aged A/R recovery. As AI learns from successful resolution patterns and begins to interpret payer behaviors and policies, it will help tackle problems that have traditionally required deep human expertise.

Another bigger shift I'm excited about is the move toward performance-based pricing models across the entire RCM ecosystem. Practices want better alignment between what they pay and the results they get - they want vendors who tie their success directly to their clients' financial outcomes.