The top BPO agencies in 2026 are Enfinity Medical Billing, Hire Live Support Inc, and MiXBS, LLC, selected from 16 agencies vetted by DesignRush on the basis of verified client reviews (4.5 avg. rating), project outcomes and industry expertise. Enfinity Medical Billing leads the ranking for BPO, followed by Hire Live Support Inc and MiXBS, LLC.
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.
DesignRush evaluates BPO providers based on verified client reviews, service capabilities, industry experience, and operational performance. Some placements may be paid.
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...
Top Services:
BPO
Location
East Brunswick, New Jersey
Number of Employees
50 - 99
Average Hourly Rate
$20/hr
Minimal Budget
Under $1,000
Portfolios Count
1 Project Listed
Enfinity Medical Billing Services
BPO
Data sourced from the agency's DesignRush profile, its website, and other relevant accounts
Greenwood Family Dentary
City Urgent Care
Malibu Medical Group
Alternative Care Physical Therapy
Rangel Dental
Madison Dental
Data sourced from the agency's DesignRush profile
Enfinity Medical Billing Reviews & Testimonials
Masaud Khan Review from Google
5.0★
Masaud Khan's Review Sourced from Google
As a healthcare provider, I have greatly benefited from Enfinity Medical Billing, both personally and for my clinic. They have made a significant positive impact on my practice, streamlining my work and making my professional life much easier.
Reviews verified by DesignRush and sourced from the agency's profile View All Reviews
Hire Live Support is a full-scale BPO service provider and a digital marketing company with 10+ years clientele and preparedness. We specialize in providing the leading live support services and new-age digital marketing gigs to SMEs, Enterprises, and Startups to delegate, scale, and manage business...
Top Services:
Call Centers
BPO
Web Design
Web Development
SEO
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Location
Cerritos, California
Number of Employees
250 - 499
Average Hourly Rate
$5/hr
Minimal Budget
Under $1,000
Portfolios Count
16 Projects Listed
Hire Live Support Inc Services
Call Centers
BPO
Web Design
Web Development
SEO
Phone Answering Services
Data sourced from the agency's DesignRush profile, its website, and other relevant accounts
Goggles4u
Savers
Hyperanimation
Eyeglasses.pk
Data sourced from the agency's DesignRush profile
Hire Live Support Inc Reviews & Testimonials
Alex Stone Review from Google
5.0★
Alex Stone's Review Sourced from Google
Partnering with Hire Live Support has been one of the best decisions for Our Company. Over the past two years, they have consistently delivered exceptional service and have handled our operations seamlessly, allowing us to focus on growth without any operational worries.We currently have a team of 13 experienced agents working with us through Hire Live Support across multiple departments, including Customer Support Representatives, Go-High Level Tech Experts, and exceptional Customer Experience Agents. The level of professionalism, dedication, and reliability they bring is truly outstanding. They have ensured smooth day-to-day functioning, provided well-trained resources, and managed our processes with complete accountability.Finding an outsourcing agency as reliable as Hire Live Support is rare. They have been the most dependable and trustworthy partner I’ve worked with, and I continue to be impressed by their commitment to excellence.I highly recommend Hire Live Support to anyone looking for a reliable outsourcing partner.
Brit Wilbanks Review from Google
1.0★
Brit Wilbanks's Review Sourced from Google
Please don't apply to companies open jobs posing as a candidate. The job market is hard enough for people out here, without businesses getting flooded with other businesses slide decks trying to make sales connections.Sincerely,The recruiter who had to look at your stupid slide deck.
Reviews verified by DesignRush and sourced from the agency's profile View All Reviews
MixBS helps businesses grow by providing market research, practical strategies, and decision-making support to achieve sustainable success...
Top Services:
Call Centers
Phone Answering Services
Customer Support
Business Consulting
BPO
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Location
Miami, Florida
Number of Employees
500 - 999
Average Hourly Rate
$12/hr
Minimal Budget
Under $1,000
Portfolios Count
4 Projects Listed
MiXBS, LLC Services
Call Centers
Phone Answering Services
Customer Support
Business Consulting
BPO
Market Research
Data sourced from the agency's DesignRush profile, its website, and other relevant accounts
CDEK
Buch
Ramayoga
Imark Tech
SovPlym
KNOVR
Data sourced from the agency's DesignRush profile
MiXBS, LLC Reviews & Testimonials
Kevin Swindlehurst Airline Operations Supervisor at Flightworx Aviation
5.0★
Customer Support Review from Kevin Swindlehurst
If youre looking for a partner thats flexible, highly skilled in multilingual customer support, and deeply knowledgeable in customer development and market research, MiXBS is the team you need. Their ability to adapt, deliver results, and provide top-tier support makes them stand out in the industry. We couldnt be happier with the partnershiptheyre exactly what we needed, and honestly, theyre awesome.
Reviews verified by DesignRush and sourced from the agency's profile View All Reviews
Vetted Virtual Assistants with a Broad Range of Expertise
myVA360 provides on-going, on-demand support for businesses of all sizes. Get matched with a dedicated virtual assistant with a wide range of skills, for a fraction of the cost of hiring an employee...
Top Services:
BPO
Location
Miami, Florida
Number of Employees
Under 49
Average Hourly Rate
$24/hr
Minimal Budget
Under $1,000
myVA360 Services
BPO
Data sourced from the agency's DesignRush profile, its website, and other relevant accounts
Kimon Services is a UK-based company specializing in cost-effective outsourced business admin solutions, including dedicated customer support, data entry, and back-office staffing. We offer managed offshore teams and Employer of Record (EOR) services tailored to client needs, helping businesses reduce costs...
Top Services:
BPO
Customer Support
Accounting
HR Outsourcing
Phone Answering Services
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Location
London, United Kingdom
Number of Employees
1000 & Up
Average Hourly Rate
$10/hr
Minimal Budget
Under $1,000
Kimon Services Services
BPO
Customer Support
Accounting
HR Outsourcing
Phone Answering Services
Data sourced from the agency's DesignRush profile, its website, and other relevant accounts
Global Guardians
GorillaHub
21st Century AV Ltd
n-gage messenger
Meeting Store
PNG CR
Data sourced from the agency's DesignRush profile
Kimon Services Reviews & Testimonials
Martin F Review from Google
5.0★
Martin F's Review Sourced from Google
Excellent company. Michael works hard to understand your needs and create a customised service around your specific requirements. The VA's have been able to accurately fulfil our scope of work and at an affordable price point.
Reviews verified by DesignRush and sourced from the agency's profile View All Reviews
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...
Top Services:
BPO
Location
Lansdale, Pennsylvania
Number of Employees
250 - 499
Average Hourly Rate
$8/hr
Minimal Budget
Under $1,000
Purview Healthcare Services
BPO
Data sourced from the agency's DesignRush profile, its website, and other relevant accounts
MedBrilliance RCM - Precision Medical Billing & Revenue Cycle Management
MedBrilliance RCM is among the USAs top medical billing companies, providing comprehensive billing, coding, and revenue cycle management services for physicians, clinics, and healthcare groups. Our team of certified medical billers and coders excels at reducing aged receivables and resolving claim denials...
Top Services:
BPO
Location
Austin, Texas
Number of Employees
50 - 99
Average Hourly Rate
$30/hr
Minimal Budget
Under $1,000
MedBrilliance Services
BPO
Data sourced from the agency's DesignRush profile, its website, and other relevant accounts
We specialize in providing accurate, timely, and efficient medical billing solutions for healthcare providers. Our expert services ensure seamless billing processes, helping you focus on patient care while we manage the complexities of billing and claims...
Top Services:
BPO
Location
Hillside, New Jersey
Number of Employees
50 - 99
Minimal Budget
Under $1,000
Mastermind Healthcare RCM Tactics Services
BPO
Data sourced from the agency's DesignRush profile, its website, and other relevant accounts
U Control Billing offers professional medical coding services that ensure accurate CPT, ICD-10, and HCPCS coding for healthcare providers. Our certified coders help reduce claim denials, maintain compliance, and improve reimbursement by translating clinical documentation into precise, billable codes that...
Top Services:
BPO
Location
Hauppauge, New York
Number of Employees
50 - 99
Minimal Budget
Under $1,000
UControl Billing Services
BPO
Data sourced from the agency's DesignRush profile, its website, and other relevant accounts
Medical Billing & Revenue Cycle Management Company
Connexus Cure is the medical billing company in United States helps healthcare practices get paid faster, reduce denials, and maximise revenue through expert medical billing & rcm services...
Top Services:
BPO
Location
Branchburg, New Jersey
Number of Employees
Under 49
Average Hourly Rate
$30/hr
Minimal Budget
Under $1,000
Connexus Cure Services
BPO
Data sourced from the agency's DesignRush profile, its website, and other relevant accounts
Scale Your Business With Quality Outsourced Teams In Back Office Support.
RPM stands out as a comprehensive solution provider, offering bilingual expertise in both English and Spanish, with the flexibility to provide full-time or part-time dedicated resources, fully managed to meet diverse operational needs. Our capabilities span a wide spectrum, encompassing intricate back-office...
Top Services:
BPO
Customer Support
Call Centers
Staff Augmentation
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Location
San Jose, California
Number of Employees
100 - 249
Minimal Budget
Under $1,000
RPM Services
BPO
Customer Support
Call Centers
Staff Augmentation
Data sourced from the agency's DesignRush profile, its website, and other relevant accounts
We are a marketing agency focusing on B2B sales lead generation, outsourcing and AI consulting. Based in the Philippines and serving the world, LeadMaker offer Lead Generation services and call center support. Our services cross multiple industries and employ a variety of methods bespoke to our clients unique...
Top Services:
Web Design
SEO
BPO
Digital Marketing
Call Centers
Show more
Location
Manila, Philippines
Number of Employees
50 - 99
Average Hourly Rate
$44/hr
Minimal Budget
Under $1,000
LeadMaker Agency Services
Web Design
SEO
BPO
Digital Marketing
Call Centers
Data sourced from the agency's DesignRush profile, its website, and other relevant accounts
MyRemoteVA delivers a unique blend of AI efficiency and skilled professional expertise to help startups, entrepreneurs, and executives save time and scale. From admin support and social media to websites and executive tasks, our Virtual Assistants work smarter with ChatGPT-powered processes that speed up...
Top Services:
BPO
Location
Kozhikode, India
Number of Employees
50 - 99
Average Hourly Rate
$6/hr
Minimal Budget
Under $1,000
My Remote VA Services
BPO
Data sourced from the agency's DesignRush profile, its website, and other relevant accounts
MetaFussion is a dynamic digital company driven by a passion for crafting innovative software solutions tailored to meet the evolving needs of businesses. Our comprehensive services, including SEO, SMM, web development, and PPC campaigns, empower clients to thrive in today's fast-paced digital environment...
Top Services:
Digital Services
Web Development
Digital Marketing
Mobile App Development
Business Consulting
Show more
Location
Brampton, Canada
Number of Employees
50 - 99
Average Hourly Rate
$10/hr
Minimal Budget
Under $1,000
MetaFussion Services
Digital Services
Web Development
Digital Marketing
Mobile App Development
Business Consulting
BPO
Social Media Marketing
eCommerce Development
Graphic Design
Logo Design
Data sourced from the agency's DesignRush profile, its website, and other relevant accounts
Adam Master Movers
Atlantic Moving
Mk Furniture
Gm Abatements
Data sourced from the agency's DesignRush profile
MetaFussion Reviews & Testimonials
Jemnii Wrost Review from Google
5.0★
Jemnii Wrost's Review Sourced from Google
Metafussion will assit you in growing your online business.They offer guidance and strategy while I focus on running my day-to-day operations.Highly recommended!
Reviews verified by DesignRush and sourced from the agency's profile View All Reviews
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...
Top Services:
Call Centers
Location
Tucson, Arizona
Number of Employees
Under 49
Average Hourly Rate
$10/hr
Minimal Budget
Under $1,000
Virtual Connect Services
Call Centers
Data sourced from the agency's DesignRush profile, its website, and other relevant accounts
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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