The top BPO agencies in 2026 are Oli AI, Expeditious Medical Billing, and Include Work, selected from 85 agencies vetted by DesignRush on the basis of verified client reviews (4.5 avg. rating), project outcomes and industry expertise. Oli AI leads the ranking for BPO, followed by Expeditious Medical Billing and Include Work.
Reviews undergo a stringent verification process to ensure reliable information about each agency from verified past clients. We’ve updated our Average Star Rating system to give you the most accurate summary of all client reviews. Read more.
Organic rankings are determined by five factors: top services, reviews, portfolio, awards/press, and team expertise. Sponsored listings pay for a placement that appears above organic positions. Sponsorship does not affect star ratings or review content - read more on our methodology page.
Make every call a useful conversation with Oli AI, an enterprise AI voice agent for inbound and outbound calls. From welcoming callers and booking appointments to qualifying leads and managing customer follow-ups, Oli AI adapts to your workflows across 22+ global languages. It connects with your business...
Medical Billing Services That Maximize Your Revenue
At Expeditious Medical Billing, we provide complete medical billing and revenue cycle management solutions for healthcare providers of all sizes. Whether you're a solo practitioner managing patient care or a growing healthcare group handling high patient volumes, our team ensures your billing process runs...
Include Work helps founders and teams save time and scale faster with expert Virtual Assistant and back-office support. With 100+ skilled VAs, we deliver reliable, high-quality solutions for admin, marketing, design, and research...
Your Perfect Partner For Improved Revenue Cycle Management Services
We are a high yield and technology empowered US Healthcare RCM outsourcing company that provides medical billing and medical coding services to prime healthcare providers across the United States...
Instant Solution is a top BPO company in Bangladesh, offering world-class call center, data management, and business support services globally. With expertise in data processing, customer support, healthcare BPO, and e-commerce, we ensure secure, accurate, and efficient solutions. Operating in Bangladesh and...
Xassure by eDesk is a trusted customer support and back-office solutions provider helping businesses deliver exceptional customer experiences. We specialize in chat support, email support, voice support, and administrative services designed to reduce workload and improve operational efficiency...
WiseLex BPO Solutions is a dynamic and client-focused business process outsourcing company, specializing in interpretation, translation, and back-office support. With a team of skilled professionals across multiple languages Including Haitian Creole, French and Spanish and more...
Your dedicated team in the Philippines, managed for you
Offshored recruits and manages dedicated full-time staff in the Philippines for Australian businesses. Each team member works for one client only, in the client's systems and hours, across finance, administration, customer service, property, estimating, drafting and marketing roles. One all inclusive monthly...
Right on Time Billing Services is a Houston-based medical billing company offering coding, claims submission, and full revenue cycle management. We help Home Health, Hospice, and Behavioral Health practices reduce denials and increase revenue...
Your Trusted Outsourced Staffing Agency & Recruitment Partner
Global Staff Network is an Australian-owned offshore staffing partner that helps businesses build reliable remote teams in the Philippines. They support growth with tailored recruitment, payroll, IT support, and managed offshore staffing across construction, admin, finance, marketing, tech, and real estate...
Building a remote team should improve operational capacity, not introduce communication gaps, management complexity, or inconsistent service delivery.Elite Sense Consulting provides remote staffing solutions for businesses seeking reliable, multilingual professionals who integrate into existing workflows...
Dedicated to provide billing solutions to medical providers.
Virtual Connect LLC was formed with the intention of supporting medical professionals and practices in achieving greater financial success. For us, it's all about the statistics. We are enthusiastic about redefining the industry and producing unparalleled results that surpass industry standards. Utilizing...
Empire Solutions is a leading BPO contact center providing expert call handling and answering services. Connect with us anywhere for top call center solutions...
Hire Global Talent Without Borders Legal Risk Or Delays
Smart Outsourcing Solution (SOS) is your partner for compliant offshore hiring. With decades of recruitment experience and strong operations in the Philippines, we deliver remote-ready talent in AI, tech, and customer support. Our EOR solution handles everything from onboarding to payroll, giving you a...
We help businesses deliver fast, reliable, and professional customer support across all channels. Whether you need inbound support, outbound follow-ups, or a dedicated remote team, we tailor our services to fit your operations and scale with your growth...
Providing offshore talent that feels like your own team. Focus on growth, we handle the rest.
We help businesses of all sizes thrive with custom outsourcing solutions. Were more than a service provider were your partner in success, offering dedicated support and seamless communication every step of the way...
ScionisRCM delivers End-to-End Revenue Cycle Management solutions for Physicians, Hospitals, Medical Practices, Specialty groups and MSO's across the U.S. We specialize in accurate medical coding, denial preventions, and clean claim submission to help practices increase collections while reducing admirative...
We Create With Your Needs And Preferences In Mind.
GoBro Web Services is a California-based web design and digital solutions agency that helps businesses strengthen their online presence through professional website design, web and app development, branding, SEO, digital marketing, and technical support services. The agency focuses on delivering modern...
Zero-fee nearshore staffing. Vetted LATAM talent in US time zones.
Virtustant places pre-vetted Latin American professionals with US companies and never charges recruitment fees: clients pay only the hire's salary, payroll and compliance included. Shortlists arrive in 48 hours, average time-to-hire is 3 days, and every placement carries a lifetime replacement guarantee...
Dedicated virtual assistants, fully vetted and fully managed.
Stellar Staff places dedicated, full-time virtual assistants with US businesses that need real capacity, not another freelancer to manage. Clients interview a shortlist of pre-vetted candidates, pick the one they want, and start in five to six days. We handle sourcing, screening, onboarding, payroll, taxes...
A Leading Outsourcing Center in Europe with the Healthy Ambition to Remain at the Top! Our business is on par with the standards established by the industry thanks to the exceptional quality and industry understanding that we provide. You may be certain that we will provide you the highest possible level of...
We provide guidance and support that acts as a seamless extension of your business. Our trained agents treat your clients with the warmth and respect they deserve, utilizing AI guidance to ensure fast, first-call resolutions without unnecessary escalations...
Billing MedTech streamlines medical billing with tech-powered solutions that boost revenue, reduce denials, and simplify RCM. Supporting 80+ practices across 35+ specialties, we help healthcare providers focus on patient care while we handle billing with accuracy, transparency, and speed...
Onwesite, A Digital Marketing Agency. We Provide Social Media Marketing, PPC, SEO, Web Design & Development, Graphic Design and Virtual Assistant Services...
Revolutionize Revenue Cycle Management For Healthcare
iSolve RCM is the best medical billing company that offers comprehensive healthcare revenue management services, with a fee as low as 2.99% of monthly collections. We serve 50+ specialties in all 50+ states. Reach out to us for expert medical billing services in USA...
We provide fully turnkey solutions handling legal setup, HR, payroll, accounting, compliance, facilities, and day-to-day supervision so our clients can focus exclusively on sales, growth, and performance. Write everything around this idea , this is the core service we offer...
Malakos Healthcare Solutions is a U.S. focused medical billing and revenue cycle management company helping healthcare practices improve reimbursements, reduce claim denials, and streamline billing operations. We support specialties including chiropractic, pain management, physical therapy, behavioral health...
Nearshore call center and VA teams, live in about 7 days
Call Force Global builds dedicated nearshore call center and virtual assistant teams from Jamaica, Trinidad, Saint Lucia, Belize, and Colombia for North American businesses. Teams go live in about 7 days at 12 to 18 USD per hour all-in, on month-to-month terms with no long contracts. Every call is scored by...
Evateck is a Business Process Outsourcing (BPO) provider helping businesses scale operations through dedicated and shared teams customer support, back-office, content moderation, and data entry. Expertise across SaaS, eCommerce, fintech, healthcare, and logistics...
CareCloud, Inc. is a prominent provider of proprietary cloud-based healthcare solutions for expanding healthcare organizations. CareCloud (Nasdaq: CCLD, CCLDP, CCLDO), formerly known as MTBC, provides the most comprehensive technology-enabled solutions to healthcare organizations of all sizes and across the...
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...
Enfinity Medical Billing optimizes revenue with expert billing, credentialing & consulting.
Enfinity Medical Billing is a healthcare revenue cycle management company that helps organizations maximize revenue and streamline operations through medical billing, transcription, credentialing, auditing, and consultation services...
A Digital Marketing Agency Led by Upworks Top-Rated Freelancers.
We are dynamic and versatile team of digital marketing experts who bring together diverse talents and experiences to deliver exceptional results for our clients...
Grow Your Business Success With All-In-One Agency Solutions
Staff BD is a full-service digital marketing agency helping brands grow through targeted strategies in social media, SEO, paid ads, and content. Trusted by startups and service businesses worldwide...
Medical Billing Services For Mental Health Professionals
.Thrive RCM is a medical billing and revenue cycle management provider specializing in services for mental health professionals, psychiatric practices, and hospitals. The company supports healthcare providers through medical billing, coding, credentialing, claims processing, denial management, payment...
VirPhone provides cloud-based business phone systems, VoIP, and UCaaS solutions designed to help companies communicate more efficiently with scalable features, advanced call handling, device flexibility, and dependable support...
First Call Solutions helps businesses grow through performance marketing, lead generation, and pay-per-call solutions. We specialize in delivering high-quality leads, inbound calls, and customer acquisition solutions across insurance, healthcare, home services, legal, and financial industries. Our focus is on...
The Peak Hire helps busy founders and growing teams reclaim their time with dependable virtual assistants matched to their actual workflows. Our remote professionals support administration, customer service, sales, recruiting, operations, bookkeeping, CRM management, scheduling, inbox management and lead...
We Focus On Customer Service So You Can Focus On Your Business.
Five Star Solutions is a premier, mid-sized contact center outsourcer dedicated to delivering world-class customer care. By blending boutique-level agility with enterprise-grade capabilities, the company serves as a seamless extension of its clients' brands...
PrimeSync Solutions is a business process outsourcing (BPO) firm that helps businesses reduce costs, scale efficiently, and deliver exceptional customer experiences. Providing top-tier talent and cutting-edge technology, the firm empowers companies to overcome operational challenges while maintaining quality...
We are a full-service dental billing organization with 1,000+ professional billers and coders across the U.S., helping dental practices boost revenue, cut costs, and focus on patient care...
DGC BPO Service is a premier US-based outsourcing company offering expert customer service, call center solutions, virtual assistance, and lead generation. We help businesses optimize operations, improve customer experiences, and drive growth with tailored, efficient solutions...
At Humalife Healthcare, we go beyond expectations by delivering high-quality digital tools and services that help healthcare providers work smarter, serve better, and grow sustainably...
We provides top-class offshore SEO virtual assistants. Hire individually or build your SEO team to be your industry's organic leader. When you need SEO support to assist with your businesss organic growth, our SEO VAs are available on an hourly, part-time, full-time, project-based, or monthly basis...
Customized RCM Strategies For US Healthcare Providers
At 𝗕𝗶𝗹𝗹𝗶𝗻𝗴 𝗖𝗮𝗿𝗲 𝗦𝗼𝗹𝘂𝘁𝗶𝗼𝗻𝘀, we are more than just a medical billing company, we are your trusted partner in maximizing revenue, minimizing claim denials, and streamlining your entire Revenue Cycle Management (RCM) process. With deep expertise in the...
MedsIT Nexus is a results-driven healthcare billing services and solutions partner specializing in accurate medical billing, coding, credentialing, and data-powered RCM solutions. We help healthcare providers improve collections, reduce denials, streamline operations, and achieve consistent financial growth...
Reducing Physician Burnout Through Accurate, Real-Time Medical Documentation
ScribeEMR provides AI-assisted and human medical scribing services that help healthcare providers reduce documentation burden and focus more on patient care. Our trained medical scribes work in real time to capture clinical encounters, maintain accurate electronic health records, and ensure HIPAA-compliant...
What you pay depends on the contract structure. There are four main models:
An hourly rate involves paying for an agent’s time regardless of how many interactions they handle. It runs:
$8 to $15 offshore
$20 to $30 nearshore
$40 to $60+ onshore
Per-agent (FTE) is a flat monthly fee of $1,200 to $4,000 per dedicated agent. Predictable, but you pay the same regardless of the volume.
Per-interaction charges $1–$5 per resolved ticket or $0.50–$2 per chat. Cost-efficient when volume is low or seasonal, but bills spike during busy periods.
Outcome-based ties fees to KPIs like CSAT scores or first-call resolution — typically $3 to $9 per successful resolution.
How do I compare two BPO providers quoting similar prices?
When two BPO firms quote similar prices, the decision should come down to industry experience, agent attrition rates, SLA terms with defined remedies, and how each vendor handles your specific exception cases, not the headline rate.
Ask for case studies from clients in your industry. A BPO company with relevant experience can start right away, while one without it will learn on your dime.
Then go beyond the deck. Give both vendors your two or three most complex support scenarios and ask them to walk you through exactly how they’d handle each one. The vendor with a documented protocol beats the one that says, “We’d escalate.”
Pay close attention to SLA clauses, specifically what happens when they’re missed, not just what the targets are. Two vendors can quote identical SLAs but differ completely on the consequences for missing them.
Finally, ask for the agent attrition rate for the specific team being proposed, not the company average. High turnover on your account means constant retraining and inconsistent service, regardless of the price.
What contract terms do most buyers accept that they shouldn’t?
The contract terms most buyers accept are auto-renewal clauses with short notice windows, SLAs with no financial remedy for misses, and IP clauses that leave process documentation owned by the vendor — all of which remove your leverage once performance drops.
Four terms worth pushing back on before you sign:
Auto-renewal clauses can trap you into a long-term agreement if the notice window is short, often 60–90 days. Miss the window, and you’re locked in for another year regardless of performance.
SLAs without consequences. Most contracts define targets but don’t specify what happens when they’re missed. Your agreement should define redressal terms, whether that’s service credits, payment for damages, or the right to exit early.
IP and process documentation ownership. Avoid clauses that grant the BPO provider exclusive rights to your intellectual property, or that allow them to sublicense or transfer it to third parties. If they own the runbooks built on your processes, switching vendors gets expensive.
Exit and termination terms need to include your ability to re-employ key personnel who hold critical knowledge of your account; otherwise, that knowledge walks out with the vendor.
The simplest check: read the contract assuming performance will eventually disappoint. If you have no leverage when that happens, negotiate before you sign.
How do BPO companies handle a sudden surge in volume?
BPO companies handle volume surges through a combination of flexible staffing, automation, and cross-trained overflow teams, but how well they execute depends entirely on what your contract says about surge capacity before it happens.
Most BPO providers have a few ways to handle sudden spikes:
Bringing in temporary agents
Moving staff from quieter channels to busier ones
Using chatbots or self-service tools to handle routine questions before they reach a human. Self-service tools can deflect 20-40% of contacts during a surge.
But not every BPO provider handles this well. When surges go unmanaged, call abandonment rates can reach 15%, which means frustrated customers and damage to your brand, not the vendor’s.
The right time to ask about this is before you sign. Find out how much notice your BPO company needs to scale up, and what the contract says about volume above your agreed tier.
A vendor who can staff up fast but delivers off-brand service during your busiest period is a liability, not a solution.
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