Our directory of top accounting firms in the US is built on five main ranking criteria and reviewed by a team of 12 experts, supported by a 4.1-star average rating from verified client reviews. This gives you a clear and reliable way to choose the best accounting firms for your business.
Discover the Best Accounting Firms in the US
14 Companies-Rankings updated: September 04, 2026
Every accounting firm featured on DesignRush is evaluated for service scope, compliance expertise, and verified client feedback. Some featured placements may be paid.
Medical Credentialing, Payer Contracting, & Billing
Medwave partners with healthcare providers across the USA to keep the revenue cycle running smoothly. Based in Cranberry Township, the team handles medical billing, insurance credentialing (CAQH, NPI, PECOS), and payer enrollment for practices of all sizes plus hands-on support for new practice startups...
Top Services:
Customer Support
BPO
Business Consulting
Accounting
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Location
Cranberry, Pennsylvania
Number of Employees
Under 49
Average Hourly Rate
$250/hr
Minimal Budget
$1,000 - $10,000
Medwave Services
Customer Support
BPO
Business Consulting
Accounting
Data sourced from the agency's DesignRush profile, its website, and other relevant accounts
Commure
Athelas
Dynapulse
Data sourced from the agency's DesignRush profile
Medwave Reviews & Testimonials
Ashley Deitz
Review from Google
5.0★
Ashley Deitz's Review Sourced from Google
Medwave Credentialing has been an outstanding partner in managing the often complex and time consuming credentialing process. Their team is knowledgeable, responsive, and incredibly detail-oriented, ensuring that everything is completed accurately and efficiently. They take the stress out of navigating insurance panels and provider enrollment, allowing me to focus more on my clients and less on administrative burdens.
Communication has been seamless from start to finish. They keep you informed every step of the way and are always available to answer questions or provide updates. Their professionalism and commitment to delivering results truly set them apart. I highly recommend Medwave Credentialing to any provider looking for reliable, efficient, and top-quality credentialing services.
Ray Nelson
Review from Google
5.0★
Ray Nelson's Review Sourced from Google
Excellent Medical Credentialing
Medwave exceeded our expectations for behavioral health credentialing services. Their team was incredibly detail-oriented, handled all paperwork efficiently, and kept us informed throughout the process. The turnaround time was faster than anticipated, which helped get our providers approved quickly.
My wife's company is pretty happy about this, they were great! I'll use again for the recredentialing.
gregory Daniel
Review from Google
1.0★
gregory Daniel's Review Sourced from Google
Unprofessional Conduct and Tardiness regarding Scheduled Meeting
I want to express my disappointment with the way a recent meeting was handled. Their team scheduled the call, yet they joined 20 minutes late without so much as an apology. To make matters worse, Alex Lau responded with irritation when we raised concerns about the delay.
This level of unprofessionalism is unacceptable and reflects poorly on any organization. Punctuality and respect for others’ time are basic expectations in any business setting.
Reviews verified by DesignRush and sourced from the agency's profile
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Together, We Can Create Your Financial Roadmap To Success
AVK Global Bookkeeping is here to help you out. They serve the cities of Phoenix, Chandler, Tempe, and Gilbert in addition to the neighboring communities, and they provide a complete variety of services to keep the financial aspects of your organization on track. Owners of businesses are well aware of how...
Top Services:
Accounting
Location
Phoenix, Arizona
Number of Employees
Under 49
Average Hourly Rate
$100/hr
AVK Global Bookkeeping Services
Accounting
Data sourced from the agency's DesignRush profile, its website, and other relevant accounts
Streamline your small business bookkeeping & reach your business goals.
Using the most up-to-date technology platforms available, Efficienxy will keep your small business running smoothly. Providing efficient and reliable virtual bookkeeping services tailored to solopreneurs, freelancers and service-based businesses...
Top Services:
Business Consulting
Accounting
Location
Rockville, Maryland
Number of Employees
Under 49
Average Hourly Rate
$75/hr
Minimal Budget
Under $1,000
Efficienxy Services
Business Consulting
Accounting
Data sourced from the agency's DesignRush profile, its website, and other relevant accounts
Barker Adoption Foundation
Wright Insurance
Heritage Chocolates
Screwtop Wine Bar
Data sourced from the agency's DesignRush profile
Efficienxy Reviews & Testimonials
Linda Urbanski
Review from Google
5.0★
Linda Urbanski's Review Sourced from Google
It has been an absolute joy working with Jessica and Carla over the past year and a half. Jessica played a key role in helping me transition into ownership of a successful wine bar in Arlington, VA and has continued to be an invaluable asset to my business. She is incredibly responsive, knowledgeable, and makes bookkeeping and tax prep feel effortless. Her guidance and support have made a huge difference in helping me stay organized and on top of my finances.
Carla is equally amazing—she manages receipts and expenses with impressive efficiency and professionalism, making QuickBooks organization a breeze. Their systems are streamlined, user-friendly, and truly designed to make a business owner’s life easier.
I genuinely don’t know what I’d do without their support. I highly recommend working with Jessica and Carla for reliable, thoughtful, and expert bookkeeping and CPA services.
Muneeb Khadeer
Review from Google
5.0★
Muneeb Khadeer's Review Sourced from Google
I have been working with Jessica over the past year and highly recommend her bookkeeping and accounting services. She has been excellent at keeping our finances organized and providing clear, accurate reports. Her attention to detail and proactive approach has been an incredible help for me and my business and has enabled us to stay on top of our financial goals.
Khalid Usmani
Review from Google
5.0★
Khalid Usmani's Review Sourced from Google
I’ve worked with Jessica for the past five years, and she has been an absolute lifesaver for my business. As a small business owner, bookkeeping and accounting used to feel overwhelming, but Jessica has taken all of that off my plate. She’s incredibly easy to work with, super responsive, and ensures everything is up-to-date and accurate from start to finish.
Her full-service capabilities mean that I never have to worry about missing a deadline or keeping up with the latest legal requirements. Jessica provides clear, comprehensive records, and always has me covered. Beyond her expertise, she’s just a really nice person who makes the whole process stress-free.
I recommend Jessica to all my friends with small businesses, and she’s the first person I think of for any bookkeeping or accounting needs. If you’re looking for someone who can simplify your financial management, I highly recommend her!
Reviews verified by DesignRush and sourced from the agency's profile
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We are an emerging IT and business consulting company providing services to industry leading clientele in North America, Europe and the Middle East. Our purpose is to enable our partners to build sustainable competitive advantage. We achieve this by enhancing organizational capabilities and optimizing...
Top Services:
eCommerce Development
Web Development
Digital Marketing
Software Development
Managed Services
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Location
Sugar Land, Texas
Number of Employees
250 - 499
Average Hourly Rate
$50/hr
Minimal Budget
$10,000 - $25,000
Murkez Technologies Services
eCommerce Development
Web Development
Digital Marketing
Software Development
Managed Services
Accounting
BPO
Data sourced from the agency's DesignRush profile, its website, and other relevant accounts
iRapidO Global is a Business Process Management organization delivering scalable back-office and operational support to growing businesses worldwide. We combine domain expertise, structured process frameworks, automation, and AI-enabled tools to help companies improve efficiency, control costs, and focus on...
Top Services:
Accounting
BPO
Business Consulting
Call Centers
HR Outsourcing
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Location
Raleigh , North Carolina
Number of Employees
250 - 499
Average Hourly Rate
$50/hr
Minimal Budget
$50,000 & Up
iRapidO Global Services
Accounting
BPO
Business Consulting
Call Centers
HR Outsourcing
Customer Support
Market Research
Phone Answering Services
IT Services
IT Compliance Solution
Data sourced from the agency's DesignRush profile, its website, and other relevant accounts
Finance
Insurance
Health Care
Data sourced from the agency's DesignRush profile
iRapidO Global Reviews & Testimonials
Nurse Gigs
Review from Google
5.0★
Nurse Gigs's Review Sourced from Google
iRapidO offers top-quality services with impressive speed and professionalism. Their team handles projects efficiently and ensures consistent, high-value results. Great service experience with strong reliability—definitely recommended for businesses needing fast and dependable solutions.
Driver Gigs
Review from Google
5.0★
Driver Gigs's Review Sourced from Google
iRapidO delivers outstanding quality and services. The team is highly professional, fast, and reliable, providing excellent results every time. Their support, pricing, and overall service experience make iRapidO one of the best choices for businesses. Highly recommended!
Abhishek Pal vlogz
Review from Google
4.0★
Abhishek Pal vlogz's Review Sourced from Google
I had a great experience working with iRapidO Global. The team is professional, responsive, and truly understands business needs. They deliver quality work on time and make collaboration smooth and efficient. I’m impressed with their expertise in global capability centers and how seamlessly they handle operations. Highly recommend them to any company looking for a reliable and experienced partner.
Reviews verified by DesignRush and sourced from the agency's profile
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Simplify your small business finances with our comprehensive bookkeeping guide and services. Learn essential tips, find affordable solutions, and stay organized for success...
Top Services:
Accounting
Location
McLean, Virginia
Number of Employees
Under 49
Average Hourly Rate
$30/hr
Prosperitee Accounting Services
Accounting
Data sourced from the agency's DesignRush profile, its website, and other relevant accounts
Your Finance Team Bookkeeping, Accounting & Strategy for One Monthly Price
CoCountant gives you a fully managed finance team that handles your books, reporting, and financial questions all for a fixed monthly fee. We work with startups and growing businesses that are tired of inconsistent freelancers, bloated firms, and DIY tools that only get you halfway there...
Top Services:
Accounting
Location
Cambridge, Massachusetts
Number of Employees
50 - 99
Average Hourly Rate
$25/hr
Minimal Budget
Under $1,000
Portfolios Count
3 Projects Listed
CoCountant Services
Accounting
Data sourced from the agency's DesignRush profile, its website, and other relevant accounts
From individuals and entrepreneurs, small and medium-sized businesses, right through to large corporations and government bodies, our administrative assistants are helping our clients become more efficient by streamlining their processes...
Top Services:
Customer Support
BPO
Market Research
Transcription Services
Translation Services
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Location
New York City, New York
Number of Employees
250 - 499
Average Hourly Rate
$24/hr
SmartPA Services
Customer Support
BPO
Market Research
Transcription Services
Translation Services
HR Outsourcing
Call Centers
Accounting
Data sourced from the agency's DesignRush profile, its website, and other relevant accounts
Cox-London
Complete Refinish
Collette CWMedia
Krispy Kreme
Total Oil and Gas
Data sourced from the agency's DesignRush profile
SmartPA Reviews & Testimonials
Vicky Grobbelaar
Review from Google
5.0★
Vicky Grobbelaar's Review Sourced from Google
Mandy has been a huge asset to Ethiqs and a lovely person to work with, efficient and friendly and a great team backing her. Highly recommended.
Pedro Mendoza
Review from Google
5.0★
Pedro Mendoza's Review Sourced from Google
Holly has been a great help recently both in terms of my business and personal affairs. I am in the process of making some business structure changes in my private dental practice and she has assisted me with all the lengthy paperwork, ensuring that everything is in order. In addition, she has assisted me in researching properties and locations. I would not hesitate in recommending her services as her support has been invaluable to me at this extremely busy time and has allowed me to focus on my patients.
Highly recommended +++++
Alexandra Stewart
Review from Google
5.0★
Alexandra Stewart's Review Sourced from Google
Terri has been an incredible SmartPA assistant for our family over the past 18 months. Her support has been invaluable in managing our busy work and home administrative tasks. Throughout our travels across Europe, the US, and Canada, as well as during our recent move to a new house and country, Terri has been there for us every step of the way. In particular, I have appreciated that Terri has used great judgment in assessing options on all fronts and hasn't just gone for the easy road of blindly following orders. I have trusted her as a "second me" and that has been so helpful. We couldn't have done any of this without her!
Reviews verified by DesignRush and sourced from the agency's profile
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Our USA-based Medical Billing Company streamlines billing operations for healthcare providers, ensuring increased revenue, reduced costs, and minimized risk. From small practices to large hospitals, we handle denials management, credentialing, coding, and payer verification with expert precision...
Top Services:
BPO
HR Outsourcing
Customer Support
Phone Answering Services
Call Centers
Show more
Location
Evesham, New Jersey
Number of Employees
50 - 99
Average Hourly Rate
$20/hr
Portfolios Count
3 Projects Listed
SwiftCare Billing LLC Services
BPO
HR Outsourcing
Customer Support
Phone Answering Services
Call Centers
Accounting
Web Design
Web Development
WordPress Website Design
Transcription Services
Data sourced from the agency's DesignRush profile, its website, and other relevant accounts
Health Care Industry
Dental Industry
Insurance Industry
HR Industry
BPO
Outsourcing
Medical Billing
Data sourced from the agency's DesignRush profile
SwiftCare Billing LLC Reviews & Testimonials
Julie Formica
Office Administrator at Redefine Healthcare
5.0★
Medical Billing Review from Julie Formica
We have been partnering with SwiftCare Billing for the past year to manage key administrative operations, including billing, accounts receivable (AR) processing, and file indexing. This collaboration has been instrumental in improving our internal workflows, reducing turnaround times, and enhancing the accuracy of our financial and document management systems.
One of the major strengths of SwiftCare Billing is their responsiveness and client service. From the initial onboarding to ongoing operations, their team has been professional, communicative, and solution-oriented. We receive regular updates and clear performance metrics, which has helped build a high level of trust in their services.
While our overall experience has been highly positive, a few initial challenges related to software integration and adapting to our internal protocols required some time and coordination. However, SwiftCare Billing showed flexibility and commitment in overcoming these hurdles, and weve since seen steady improvements in alignment and efficiency.
Overall, SwiftCare Billing has proven to be a reliable, professional, and valuable partner. Their services in billing, AR, and file indexing have added measurable value to our operations, allowing our in-house team to focus on core business activities. We would not hesitate to recommend their services to other organizations seeking a capable and trustworthy outsourcing provider.
Reviews verified by DesignRush and sourced from the agency's profile
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Taskforce BPO is an American Veteran owned company whose mission is to provide clients with labor solutions that enable them to focus on their core competencies while increasing productivity and profitability...
Top Services:
Call Centers
Accounting
Location
Knoxville, Tennessee
Number of Employees
100 - 249
Average Hourly Rate
$20/hr
Minimal Budget
$1,000 - $10,000
Taskforce Services
Call Centers
Accounting
Data sourced from the agency's DesignRush profile, its website, and other relevant accounts
The Dental Services is a US-based dental business solutions provider specializing in billing, credentialing, and practice support services, helping dental clinics streamline operations and improve financial performance through efficient and compliant processes...
Top Services:
Business Consulting
Accounting
Location
Philadelphia, Pennsylvania
Number of Employees
Under 49
Average Hourly Rate
$20/hr
Minimal Budget
$1,000 - $10,000
The Dental Services Services
Business Consulting
Accounting
Data sourced from the agency's DesignRush profile, its website, and other relevant accounts
Allianze Infosolution is a leading BPO and AI data automation company in the USA offering data processing, virtual assistance, finance, healthcare, and engineering solutions...
Top Services:
BPO
Accounting
Location
Denver, Colorado
Number of Employees
50 - 99
Average Hourly Rate
$20/hr
Minimal Budget
$1,000 - $10,000
Allianze Infosolution Services
BPO
Accounting
Data sourced from the agency's DesignRush profile, its website, and other relevant accounts
Cover Operation is a high level and cost-effective insurance BPO solutions. Our unparalleled advantage is to hire 5-8 years' experienced insurance processors from world's top 3 insurance outsourcing vendors to work for you with a much lower price. Our optimized management will boost your productivity and...
Top Services:
BPO
Accounting
Location
Twentynine Palms, California
Number of Employees
50 - 99
Average Hourly Rate
$12/hr
Minimal Budget
Under $1,000
Cover Operation Services
BPO
Accounting
Data sourced from the agency's DesignRush profile, its website, and other relevant accounts
Offshore Data Entry Service: Precision, Speed and Security
Top Offshore BPO company...
Top Services:
BPO
Accounting
Customer Support
Market Research
Web Design
Show more
Location
Chicago, Illinois
Number of Employees
100 - 249
Average Hourly Rate
$5/hr
Minimal Budget
$10,000 - $25,000
Portfolios Count
4 Projects Listed
Offshore India Data Entry Services
BPO
Accounting
Customer Support
Market Research
Web Design
Phone Answering Services
Data sourced from the agency's DesignRush profile, its website, and other relevant accounts
allianze bpo
nexgen
india data entry
Data sourced from the agency's DesignRush profile
Offshore India Data Entry Reviews & Testimonials
Lisa Rozario
Marketing Manager at D.E Exports LLC
5.0★
Document Digitization Review from Lisa Rozario
We approached offshore data entry for our data entry process. They adeptly transformed our process. An excellent and efficient team, delivering quality work on time. I recommend Offshore India Data Entry for data entry requirements.
Reviews verified by DesignRush and sourced from the agency's profile
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Monthly transaction volume reaches 40-50 or more entries
Payroll, tax filings, or reporting begin consuming operational time
At those stages, manual bookkeeping becomes inefficient and increases the risk of errors or missed compliance deadlines.
Accounting outsourcing is also driven by efficiency. Around 65% of businesses outsource finance and accounting tasks to free up internal resources and focus on growth.
As requirements expand, they provide structure, accuracy, and regulatory oversight that small internal teams often struggle to maintain.
What accounting services do most top accounting companies offer in the US?
The best accounting firms in the US typically provide a mix of core financial, compliance, and advisory services.
Common offerings include:
Bookkeeping and bank reconciliations
Financial statement preparation
Payroll processing
Accounts payable and receivable management
Tax planning and federal, state, and local tax filings
Many firms also offer:
Budgeting and forecasting
Cash flow and financial performance analysis
Audit preparation and internal controls assessments
Compliance support under U.S. Generally Accepted Accounting Principles (GAAP)
Many businesses outsource several accounting functions at the same time, which is why US companies typically offer these services as bundled, ongoing engagements rather than isolated tasks.
This approach aligns with the scale of the finance and accounting outsourcing market, which stood at $54.79 billion in 2025.
How much does it cost to hire top accounting firms in the United States?
The cost of hiring one of these firms in the United States depends on business size, transaction volume, and service complexity. Typical pricing includes:
$300-$800 per month for basic bookkeeping and reconciliations
$150-$400 per hour for specialized CPA services
$800-$2,500 per month for comprehensive monthly packages (payroll, reporting, tax support)
$2,500-$5,000+ per month for mid-sized or higher-complexity businesses
At a macro level, the global accounting outsourcing market is expected to exceed $80 billion by 2030, as companies pursue cost efficiencies of 20-60% compared to maintaining full in-house accounting teams.
What additional costs can I expect from these types of companies?
In addition to base retainers, they often charge for specialized or non-recurring services, such as:
Year-end financial statements
Multi-state or corporate tax filings
Audit preparation
System migrations
International compliance
Advisory or consulting projects
Other common add-ons include payroll setup, budgeting assistance, and financial forecasting.
For many growing businesses, these services increase total annual accounting spend by 20-40% beyond base fees.
While this raises short-term costs, outsourcing often reduces overall operating expenses by eliminating the need for full-time internal finance staff and minimizing compliance risks.
What do I need to know before I switch to a top accounting firm?
Switching companies usually involves a transition period of 4-8 weeks. During this time, businesses should be prepared to provide:
2-3 years of financial statements
Prior tax filings
Payroll records
Access to accounting software
A brief overlap between outgoing and incoming firms is common and helps:
Resolve open items
Prevent reporting gaps
Ensure continuity of compliance
Planning the transition outside of peak tax or reporting seasons further reduces disruption and operational risk.