Your backlog isn't going to clear itself. And hiring won't get you there fast enough.
You're processing thousands of claims a week. Your queues are growing faster than your team. Every new client adds volume your back office wasn't sized to absorb. The board wants margin. Operations wants headcount. Neither is going to win.
Hired Billing Support is the backend processing engine for healthcare operations at scale. Embedded in your systems, accountable to your SLAs, elastic enough to double when your volume does.
— Operations dashboard · Queue status
You know exactly where the bottleneck is. You can't hire your way out fast enough.
The pipeline is full. Your sales team is closing new accounts. Operations is the constraint.
Team leads are working evenings. Average handle time is creeping up. SLA breach reports are landing on someone's desk every week. Two of your best processors gave notice last month, and replacements are two months out.
You can hire — but training a new processor to full productivity is 90-120 days. You can buy software — but software doesn't work the queues.
What you actually need is throughput. Today. Not next quarter.
You don't have a hiring problem. You have a capacity elasticity problem.
Traditional operations scale the way furniture is built — slow, fixed, expensive. You commit to headcount, real estate, training infrastructure, and management overhead, and you bear the cost whether volume is at peak or trough.
But healthcare volume isn't smooth. It spikes on new client launches. It surges at the start of every benefit year. It dips, then bursts. Your fixed cost structure can't move with it.
We act as your backend processing engine. Embedded. Elastic. Accountable.
We don't replace your leadership, your systems, or your client relationships. We provide the throughput layer underneath them — staffed by trained healthcare specialists, supported by AI-assisted workflows, and accountable to your SLAs.
You'll have a dedicated team lead from our side who interfaces with your operations manager. You set the SOPs. We execute them. Queue depth, AHT, accuracy, and SLA performance — visible in a shared dashboard, updated in real time.
When your volume doubles next quarter, we scale with you in days. When it drops, we scale back without severance cost.
Backend processing. Complete coverage.
All deliverable under a white-label arrangement if your client relationships require it.
Claims processing at volume
Submission, adjudication support, payer follow-up, exception handling.
Eligibility & benefits verification
Real-time and batch processing across all major payers.
Prior authorization processing
Pre-cert submission, payer follow-up, status tracking at scale.
AR resolution
Aging bucket clearance, payer escalation, root-cause analysis.
Denial management & appeals
Categorization, routing, appeal authoring, overturn tracking.
Payment posting & reconciliation
ERA/EOB posting, exception research, daily reconciliation.
Credentialing support
Application processing, follow-up, maintenance cycles.
Data entry & document processing
Demographics, charge entry, document indexing at throughput volume.
Quality assurance & audit
Sample-based QA on all processed work. Accuracy tracking.
Reporting & analytics
Queue reporting, SLA dashboards, root-cause analysis.
We slot into your operation. Not the other way around.
We work in your systems.
Your platform. Your ticketing. Your reporting tools. No migration. No duplication.
We follow your SOPs.
Your QA standards. Your escalation rules. Your client-specific protocols. Documented and executed against.
We report into your ops leadership.
Dedicated team lead. Daily syncs. Weekly SLA review. Monthly capacity planning.
We flex with your volume.
Scale up in days. Scale back without cost. Operations becomes a variable cost, not fixed.
AI compresses the volume. Humans handle the exceptions.
At MSO and aggregator scale, AI matters more — not less. We use AI-assisted workflows for claim scrubbing, eligibility batching, denial categorization, and document classification. Throughput per processor goes up 2-4x on routine work.
The exceptions — denied claims needing root-cause analysis, payer escalations, complex appeals, edge-case eligibility — get a trained human every time. Because automated decisions on exceptions are how aggregators lose clients.
The ratio matters. AI does the volume work. Human time is preserved for the work that decides whether your client renews.
What scaling with us looks like.
Why not just build it in-house?
You can. Here's what it looks like.
Tell us the volume. We'll show you the model.
Current volume, projected growth, top three bottlenecks. We'll come back with a capacity model and integration plan — typically within 7 business days.