Top BPO Service Companies in the USA

The SME ranking on this page lists 291 small and medium-sized companies, and 58 of them earned a rank number. Three businesses known to be large are left out. The SME order does not reward age, so newer firms compete on evidence alone. See the SME ranking

1. =49

   

   Bright Vision Transcription Services

   Medical · Legal · Personnel · Also in Lahore and Adelaide

   Bright Vision Transcription Services turns dictated audio into written records, specialising in medical work but also handling legal and business material.

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   Why #49 (shared): Based in Austin, Texas, United States · Founded 1999, as stated on its own website, read 28 Sept 2026

   Not yet on record: client reviews, vetting.

2. =49

   

   lakeshoremb

   lakeshoremb, also known as Lakeshore Medical Billing, is a billing company based in Grand Haven, Michigan.

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   Why #49 (shared): Based in Grand Haven, Michigan · Founded 1999, as stated on its own website, read 5 Oct 2026

   Not yet on record: client reviews, vetting.

3. =49

   

   Ems CRM

   EMS CRM is a call centre provider based in the United States that has operated since 1999.

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   Why #49 (shared): Based in United States · Founded 1999, as stated on its own website, read 29 Sept 2026

   Not yet on record: client reviews, vetting.

4. =52

   

   360 Medical Billing Solutions

   Best for: Emergency and urgent care billing

   Medical Billing · Medical · Insurance · Also in Houston

   360 Medical Billing Solutions handles billing, coding and revenue cycle work for emergency and urgent care providers in the United States.

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   Why #52 (shared): Based in Oklahoma City, United States · Founded 2000, as stated on its own website, read 28 Sept 2026

   Not yet on record: client reviews, vetting.

5. =52

   

   Fast Track Medical Billing LLC

   Medical Billing · Medical · Insurance · Also in New Jersey and Florida

   Fast Track Medical Billing LLC is a medical billing company that manages insurance claims and billing for doctors' offices.

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   Why #52 (shared): Office in United States of America · Founded 2000, as stated on its own website, read 5 Oct 2026

   Not yet on record: client reviews, vetting.

6. =54

   

   Billing department

   Billing department, trading as The Billing Department, handles medical billing and practice consulting for independent healthcare providers in the United States.

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   Why #54 (shared): Based in United States · In business 25+ years, as stated on its own website, read 28 Sept 2026

   Not yet on record: client reviews, vetting.

7. =54

   

   Eplus Marketing

   Eplus Marketing is a marketing practice based in St. Louis, serving businesses there and across the United States.

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   Why #54 (shared): Based in St. Louis, United States · In business 25+ years, as stated on its own website, read 29 Sept 2026

   Not yet on record: client reviews, vetting.

8. =54

   

   JDT Medical Billing

   Medical Billing · Medical

   JDT Medical Billing, Ltd. is a medical billing company in Chicago.

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   Why #54 (shared): Based in Chicago, Illinois · In business 25+ years, as stated on its own website, read 5 Oct 2026

   Not yet on record: client reviews, vetting.

9. =54

   

   Bradford Medical Associates

   Medical Billing · Medical · Also in Massachusetts and Bradford

   Massachusetts medical billing company helping physician practices of every specialty with billing and practice management

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   Why #54 (shared): Based in Andover, Massachusetts · In business 25+ years, as stated on its own website, read 28 Sept 2026

   Not yet on record: client reviews, vetting.

10. =54

    

    Interchanges

    Lead Generation · Non Profit · Partners · Also in Nelson

    Interchanges is a digital marketing company in Jacksonville, Florida, focused on generating leads and growing revenue for business clients.

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    Why #54 (shared): Based in Jacksonville, Florida, United States · In business 25+ years, as stated on its own website, read 5 Oct 2026

    Not yet on record: client reviews, vetting.

11. =54

    

    Indecomm Global Services

    Mobile App Development · Web Development · iOS App

    Indecomm Global Services serves the US mortgage industry, with headquarters in Edison, New Jersey. It supports every stage of the mortgage lifecycle.

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    Why #54 (shared): Based in Edison, New Jersey · In business 25+ years, as stated on its own website, read 6 Oct 2026

    Not yet on record: client reviews, vetting.

12. =60

    

    GenSales

    Lead Generation · Outsourcing · Partners

    GenSales is a US-based outsourced sales company that has offered B2B lead generation and appointment setting since 2002.

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    Why #60 (shared): Based in United States · Founded 2002, as stated on its own website, read 29 Sept 2026

    Not yet on record: client reviews, vetting.

13. =60

    

    C3i3 Interactive

    Web Design · SEO · Creative

    C3i3 Interactive is a web design and development company in Alameda, California, working with businesses across the San Francisco Bay Area, including San Jose and Oakland.

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    Why #60 (shared): Based in Alameda, California · Founded 2002, as stated on its own website, read 28 Sept 2026

    Not yet on record: client reviews, vetting.

14. =62

    

    Document Solutions

    Consumer Products & Services · Non Profit · Information Technology

    Document Solutions supplies and supports office technology for organisations in New Jersey.

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    Why #62 (shared): Based in Kenilworth, New Jersey, USA · In business 23+ years, as stated on its own website, read 29 Sept 2026

    Not yet on record: client reviews, vetting.

15. =62

    

    ExtraDent

    ExtraDent provides software and back-office services that handle dental insurance paperwork for dental practices.

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    Why #62 (shared): Based in Indianapolis, Indiana, USA · Founded 2003, as stated on its own website, read 5 Oct 2026

    Not yet on record: client reviews, vetting.

16. =62

    

    Canyon Medical Billing

    Canyon Medical Billing works with healthcare providers in Nevada who treat personal injury patients.

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    Why #62 (shared): Based in Nevada, USA · Founded 2003, as stated on its own website, read 28 Sept 2026

    Not yet on record: client reviews, vetting.

17. =65

    

    LeadJen

    Private Equity · Medical · front

    LeadJen is a lead generation company based in Indianapolis. It supplies outsourced sales development representatives who find prospects and book meetings for client sales teams.

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    Why #65 (shared): Based in Indianapolis, USA · Founded 2004, as stated on its own website, read 5 Oct 2026

    Not yet on record: client reviews, vetting.

18. =65

    

    InStream

    Government · Automation

    InStream is a business process company headquartered in Nashville, Tennessee. It helps organisations work more efficiently through automation and tailored processes.

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    Why #65 (shared): Based in Nashville, Tennessee · Founded 2004, as stated on its own website, read 5 Oct 2026

    Not yet on record: client reviews, vetting.

19. =65

    

    Genuine Web

    SEO · Internet · Also in California

    Genuine Web is a web design and online marketing company in Bakersfield, California.

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    Why #65 (shared): Based in Bakersfield, California, USA · In business 22+ years, as stated on its own website, read 29 Sept 2026

    Not yet on record: client reviews, vetting.

20. 68

    

    Bikham Healthcare

    Information Technology · Outsourcing · Education · Also in York

    Bikham Healthcare is the healthcare arm of Bikham, a company set up in 2005 that now describes itself as a healthcare technology business.

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    Why #68: Office in United States of America · Founded 2005, as stated on its own website, read 28 Sept 2026

    Not yet on record: client reviews, vetting.

21. =69

    

    Acclaim Medical Billing

    Acclaim Medical Billing is a locally owned billing company serving doctors in San Antonio, Texas, and nearby areas.

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    Why #69 (shared): Based in San Antonio, Texas · In business 20+ years, as stated on its own website, read 28 Sept 2026

    Not yet on record: client reviews, vetting.

22. =69

    

    GlowTouch Technologies

    Call Center · Outsourcing · Partners · Also in Karnataka and Bangalore

    Customer support, back-office processing and technology staffing are the core of GlowTouch Technologies, a business process outsourcing provider based in Louisville.

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    Why #69 (shared): Based in Louisville, with offices in Mangalore and Bangalore · In business 20+ years, as stated on its own website, read 29 Sept 2026

    Not yet on record: client reviews, vetting.

23. =69

    

    Callbox

    Advertising & Marketing · Hospitality & Leisure · Business Services

    Callbox is a B2B lead generation and appointment setting agency that finds prospects and books meetings with decision-makers for its clients' sales teams.

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    Why #69 (shared): Address in United States of America · In business 20+ years, as stated on its own website, read 28 Sept 2026

    Not yet on record: client reviews, vetting.

24. =69

    

    JustSimple

    JustSimple is a web design and digital marketing agency. Its earlier profile places it in Kuala Lumpur, Malaysia, while its current website pitches web design services to…

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    Why #69 (shared): Based in Kuala Lumpur, Malaysia (earlier profile); US-facing website · In business 20+ years, as stated on its own website, read 5 Oct 2026

    Not yet on record: client reviews, vetting.

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