The top BPO agencies in 2026 are Keach Assistants, MediBill RCM, and Dastify Solutions, selected from 18 agencies vetted by DesignRush on the basis of verified client reviews (4.5 avg. rating), project outcomes and industry expertise. Keach Assistants leads the ranking for BPO, followed by MediBill RCM and Dastify Solutions.

#AgencyRatingMin projectHourlyLocation
1Keach Assistants 4.6 (3) $1,000 - $10,000$10/hrHouston, Texas
2MediBill RCM New $1,000 - $10,000$30/hrHouston, Texas
3Dastify Solutions New $1,000 - $10,000$15/hrAustin, Texas
4Humalife Healthcare New $1,000 - $10,000$25/hrClaymont, Delaware
5Swagpro Medical Billing Services New $1,000 - $10,000$1000/hrLincoln, Nebraska
4.5 avg. rating from 447 verified reviews
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Wellness & Fitness × $1,000 - $10,000 ×

Best BPO Providers

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.

  • Transform Your Workflow with Highly Skilled Virtual Assistants.

    Keach Assistants is a U.S.-based virtual assistant company specializing in providing expert bookkeeping, accounting, eCommerce, and data entry services. Our team of highly skilled virtual assistants is equipped to handle the complexities of modern business tasks, helping you streamline operations and improve...

    Top Services:

    • BPO
    Location
    Houston, Texas
    Number of Employees
    Under 49
    Average Hourly Rate
    $10/hr
    Minimal Budget
    $1,000 - $10,000
  • Enhancing Healthcare Rcm With Superior Accuracy and Efficiency

    MediBill RCM is leading medical billing and coding company in the U.S, based in Texas. As an accredited online medical billing and coding company in America, our certified specialists support your practice from patient arrival to payment, focusing on improving your revenue cycle management...

    Top Services:

    • BPO
    • Business Consulting
    • Transcription Services
    Location
    Houston, Texas
    Number of Employees
    100 - 249
    Average Hourly Rate
    $30/hr
    Minimal Budget
    $1,000 - $10,000
  • AI-Powered Medical Billing Company

    Dastify Solutions is a Texas medical billing and revenue cycle management company serving U.S. practices. Founded in 2024...

    Top Services:

    • BPO
    • Managed Services
    • Customer Support
    Location
    Austin, Texas
    Number of Employees
    50 - 99
    Average Hourly Rate
    $15/hr
    Minimal Budget
    $1,000 - $10,000
    Portfolios Count
    1 Project Listed
  • Grow Your Healthcare Business With Us

    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...

    Top Services:

    • BPO
    Location
    Claymont, Delaware
    Number of Employees
    50 - 99
    Average Hourly Rate
    $25/hr
    Minimal Budget
    $1,000 - $10,000
  • Swagpro Medical Billing Services

    Swagpro Medical Billing Services is recognized as the best medical billing company in Nebraska, offering top-quality, end-to-end medical billing services in Nebraska...

    Top Services:

    • BPO
    Location
    Lincoln, Nebraska
    Number of Employees
    50 - 99
    Average Hourly Rate
    $1000/hr
    Minimal Budget
    $1,000 - $10,000
  • 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...

    Top Services:

    • BPO
    Location
    Edison, New Jersey
    Number of Employees
    250 - 499
    Average Hourly Rate
    $15/hr
    Minimal Budget
    $1,000 - $10,000
  • Healthcare Billing Services And Solution In USA

    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...

    Top Services:

    • BPO
    Location
    Uniondale, New York
    Number of Employees
    100 - 249
    Average Hourly Rate
    $25/hr
    Minimal Budget
    $1,000 - $10,000
  • Scalable 24/7 Support Teams

    Quicklyster provides fully managed 24/7 customer support and Tier 1 tech support for SaaS, eCommerce, and digital-first brands. We offer free backup agents, fast deployment, native English agents, and flexible pricing all without contracts or setup fees. Whether you need live chat, phone, email, or helpdesk...

    Top Services:

    • BPO
    • Social Media Marketing
    Location
    New York City, New York
    Number of Employees
    50 - 99
    Average Hourly Rate
    $9/hr
    Minimal Budget
    $1,000 - $10,000
  • Hire top LATAM marketing talent

    Hypeify helps startups and high-growth companies scale marketing teams affordably by sourcing top-tier marketing talent from Latin America. We connect you with vetted marketing specialists in social media, paid ads, email, content, design, video, web, and analytics. With flexible plans, full onboarding...

    Top Services:

    • BPO
    • HR Outsourcing
    Location
    Palm Springs, Florida
    Number of Employees
    Under 49
    Average Hourly Rate
    $15/hr
    Minimal Budget
    $1,000 - $10,000
  • Small Business Accounting, Technology, & Growth Consulting.

    Fred Lundin CPA LLC is a Chicago-based CPA accounting and technology consulting firm specializing in serving e-commerce, solopreneurs, and small business owners. With a dedicated focus on these sectors, we provide tailored financial and technological solutions to help our clients thrive in their respective...

    Top Services:

    • Business Consulting
    • Market Research
    • Accounting
    • BPO
    • CRM Consulting
    • Show more
    Location
    Chicago, Illinois
    Number of Employees
    Under 49
    Average Hourly Rate
    $150/hr
    Minimal Budget
    $1,000 - $10,000
    Portfolios Count
    3 Projects Listed
  • Connecticut's Premier Medical Billing Solutions

    ANR Medical Billing LLC is a Connecticut-based revenue cycle management company helping healthcare providers maximize reimbursements and reduce claim denials. We specialize in end-to-end medical billing, coding, credentialing, and denial management for practices across the USA...

    Top Services:

    • BPO
    • Transcription Services
    • Business Consulting
    Location
    New London, Connecticut
    Number of Employees
    Under 49
    Average Hourly Rate
    $30/hr
    Minimal Budget
    $1,000 - $10,000
  • Experience You Can Trust

    Star Billing Solutions is a medical billing and revenue cycle management (RCM) company that helps healthcare providers improve financial performance through accurate, compliant, and efficient billing services. The company specializes in streamlining billing workflows, reducing claim denials, and accelerating...

    Top Services:

    • BPO
    • Customer Support
    • Transcription Services
    • Phone Answering Services
    • CRM Consulting
    • Show more
    Location
    Phoenix, Arizona
    Number of Employees
    50 - 99
    Average Hourly Rate
    $10/hr
    Minimal Budget
    $1,000 - $10,000
  • Maximizing Revenue & Simplifying Medical Billing For Healthcare Practices

    Nevada Med Billing is a Nevada based medical billing and revenue cycle management company built for Nevada healthcare practices. We work exclusively with Nevada healthcare providers, which means Nevada Medicaid's managed care plans, the Culinary Health Fund, and Nevada's surprise billing law aren't things we...

    Top Services:

    • BPO
    • Accounting
    • Business Consulting
    • Transcription Services
    • Customer Support
    • Show more
    Location
    Las Vegas, Nevada
    Number of Employees
    100 - 249
    Average Hourly Rate
    $25/hr
    Minimal Budget
    $1,000 - $10,000
  • Trust your buddy to have your back!

    Hire globally, stress-free, with a reliable Virtual Assistant for just $10/hour no contracts, no setup fees, no hassle. Pixel Buddys dedicated Virtual Buddies take care of time-consuming tasks so you can focus on growing your business and enjoying life.Trust your buddy to have your back!...

    Top Services:

    • HR Outsourcing
    • BPO
    Location
    Pueblo, Colorado
    Number of Employees
    50 - 99
    Average Hourly Rate
    $8/hr
    Minimal Budget
    $1,000 - $10,000
  • Transforming Your Ideas Into Reality

    Tasks Expert provides highly skilled virtual assistants for businesses worldwide, offering administrative, marketing, bookkeeping, website development, and customer support services tailored to business needs...

    Top Services:

    • Customer Support
    • BPO
    Location
    Kansas City, Missouri
    Number of Employees
    50 - 99
    Average Hourly Rate
    $5/hr
    Minimal Budget
    $1,000 - $10,000
  • 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...

    Top Services:

    • Transcription Services
    • BPO
    Location
    Woburn, Massachusetts
    Number of Employees
    1000 & Up
    Average Hourly Rate
    $25/hr
    Minimal Budget
    $1,000 - $10,000
  • Outsourcing Led By Your Most Trusted Partner

    Olymp BPO is a specialized outsourcing partner that delivers high-performance web development and comprehensive customer support solutions...

    Top Services:

    • Web Development
    • Mobile App Development
    • BPO
    • Phone Answering Services
    • AI Development
    • Show more
    Location
    Pristina, Kosovo
    Number of Employees
    50 - 99
    Average Hourly Rate
    $10/hr
    Minimal Budget
    $1,000 - $10,000
  • Your success our process.

    BolsterBiz specializes in offshoring services designed to optimize efficiency and boost business performance. Our tailored solutions, including 24/7 Customer Support, Digital Marketing, and Data Analytics, cater to your unique business needs...

    Top Services:

    • Customer Support
    • Staff Augmentation
    • BPO
    Location
    Wilmington, Delaware
    Number of Employees
    100 - 249
    Average Hourly Rate
    $8/hr
    Minimal Budget
    $1,000 - $10,000

Why companies trust DesignRush

Every agency is independently vetted before it can be listed or ranked

1

Identity Check

We verify businesses and reviewer LinkedIn profiles for integrity.

Agencies vetted
132,332+
2

Portfolio Review

We review agency work, case studies, and results to confirm skill.

Applicants rejected
48%
3

Ongoing Audit

We monitor listings regularly; outdated agencies are removed.

Agencies verified
18

Some agencies pay for sponsored placement, clearly labeled and held to the same vetting standards.

See how rankings and monetization work.

4 Frequently Asked Questions About BPO Companies

How much do BPO providers charge for their services?

Business process outsourcing, or BPO companies, charge between $8 and $60 per hour for customer service, with monthly per-agent rates ranging from $1,200 to $4,000 depending on location, skill level, and support complexity. 

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: 

  1. 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. 
  2. 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. 
  3. 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. 
  4. 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.