The scope of outsourceable functions depends on the billing company’s internal capabilities and client requirements. Here is how most partnerships are structured:
High-volume, process-driven functions (most commonly outsourced):
- Charge entry and claim scrubbing — rules-based, high-volume work that benefits from dedicated capacity
- Payment posting — ERA and manual EOB processing across multiple payers and practice management systems
- Insurance eligibility verification — batch verification before appointments, often handled as overnight processing
- Claim submission and status tracking — ensuring claims are submitted clean and followed up within payer windows
High-expertise functions (outsourced when specialist skills are needed):
- Medical coding — CPT, ICD-10, E/M coding across specialties; often outsourced for overflow or specialty-specific volume
- Denial management and appeals — requires deep payer knowledge and persistence; strong ROI when done well
- Underpayment recovery — contract-level auditing of paid claims to identify systematic underpayments
Project-based outsourcing:
- AR cleanup — billing companies often engage back-office partners for time-limited AR recovery projects on aged accounts
- New client onboarding support — handling the initial backlog when a new client comes on board
Squadyen functions as a white-label back-office partner across all of the above — integrating into the billing company’s workflows, software, and reporting structure without the client knowing Squadyen is involved.