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7 Best Claims Resolution Specialist Companies (2026)
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7 Best Claims Resolution Specialist Companies (2026)
7 Best Claims Resolution Specialist Companies (2026)
Medical Billing & Coding
Claims Resolution Specialist

7 Best Claims Resolution Specialist Companies (2026)

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    7 Best Claims Resolution Specialist Companies (2026)

    Last updated: 2026-08-24

    Honest Taskers ranks first on our 2026 list of claims resolution specialist companies, with healthcare-trained assistants, including licensed nurses and physicians, at $10.00–$12.65/hr and a signed BAA before PHI access. Plutus Health and AGS Health are the closest alternatives.

    Honest Taskers, Plutus Health, and AGS Health lead this year's shortlist of claims resolution specialist companies, seven firms ranked on how they close out the claims that follow-up alone cannot fix, from reading the denial reason and correcting the underlying error to building and filing appeals, working reconsiderations, handling underpayments, and taking a genuine dispute through to a formal process. Resolution differs from follow-up in one way that decides the whole comparison: it needs somebody who can determine why a claim was denied and change something, not just ask again.

    Disclosure: Honest Taskers publishes this list and appears at position 1. We're judged on the same five published criteria as every other company here.

    At a glance

    1. 1Honest Taskers
    2. 2Plutus Health
    3. 3AGS Health
    4. 4Transcure
    5. 5Waystar
    6. 6Neolytix
    7. 7Staffingly

    On this page

    • How we chose the best claims resolution specialist companies
    • Best claims resolution specialist companies compared
    • The 7 companies
    • Should denials be resolved in-house by a specialist, outsourced, or prevented?
    • What are the risks of outsourcing to a claims resolution specialist?
    • How is a claims resolution specialist priced?
    • What should you look for in a claims resolution specialist?
    • How do you hand denial resolution to a specialist?
    • Methodology and sources

    How we chose the best claims resolution specialist companies

    We ranked these firms on five facts, each read at the provider's own website in August 2026. Those facts are what resolution work is performed, what credentials or certifications are stated, published pricing, the purchase model, and named compliance. Resolution capability leads because the word covers three different depths. Correcting a demographic or coding error and resubmitting is clerical. Writing an appeal that cites the policy and the clinical record is skilled work. Taking an out-of-network dispute through independent dispute resolution under the No Surprises Act is specialist work that only one firm here names. We say which depth each firm is selling. Blank facts read "not publicly listed" instead of a guess.

    Best claims resolution specialist companies compared

    The table ranks all 7 on the same columns, Honest Taskers first because we publish the list. Facts were read August 2026 and change often, so treat them as a starting point, not a quote.

    Claims resolution specialist companies compared on the criteria stated below, read at each provider's own site.
    CompanyResolution work coveredCredential or certification statedPublished pricingPurchase modelCompliance named
    Honest TaskersDenial reason capture, correction and resubmission, appeal packet assembly, records requests, reconsideration trackingNone claimed for coding; pool includes licensed nurses and physicians$10.00–$12.65/hrStaffing by the hourCompliance officer; HIPAA compliance verified by Accountable; BAA when PHI is accessed
    Plutus HealthDenial management, complex claims, NSA independent dispute resolution, insurance discovery, DRG validation, coding auditAAPC-certified audits referenced; 99.2% coding accuracy thresholdNot publicly listedOutsourced service plus AI agentsHIPAA; SOC 2 Type II
    AGS HealthDenials, claims, accounts receivable, coding, CDI, prior authorization"Cybersecurity Transparent Designation 2023"; no coder credential namedNot publicly listedOutsourced serviceNamed designation only; no SOC 2, ISO or HITRUST
    TranscureRCM including audits, coding correction, eligibility and credentialingAAPC-certified billers and coders (company-reported)3% to 5% of monthly collectionsPercentage of collectionsISO 27001 (company-reported)
    WaystarDenial and Appeal Management, Recoupment Manager, Claim Manager, prebill anomaly detection, DRG anomaly detectionNot applicable; your staff work the queuesNot publicly listedSoftware licenseHIPAA, SOC 2, HITRUST, PCI-DSS
    NeolytixRCM including denials, coding audit, credentialing, provider enrollment, payer contract workNot publicly listedNot publicly listedOutsourced service plus staffingISO 27001 certified; HIPAA stated
    StaffinglyRemote staff for billing, coding, prior authorization and documentation workNot publicly listed$399/wk at 45 hours; $349 at 5+; $299 at 10+Placed remote staff, flat weeklySOC 2 Type II, ISO/IEC 27001:2022, signed BAA, $5M E&O and cyber policy (company-reported)

    One firm names No Surprises Act independent dispute resolution, which is the deepest resolution capability on the list and the one most practices discover they need only after a large out-of-network claim goes wrong. Two firms publish prices in opposite structures, contingent and flat. And one entry is software whose real contribution is upstream: prebill and DRG anomaly detection stop the denial happening rather than resolving it afterwards, which is cheaper than any of the alternatives.

    1. Honest Taskers

    Best for: practices where most denials are fixable errors and nobody has time to fix and resubmit them.

    Pricing: $10.00–$12.65/hrLocation: US clients; PH, LatAm, India and Pakistan recruitingModel: Staffing by the hourFirst hire: Two-week working trial

    A large share of denials are not disputes. They are a wrong subscriber number, a missing authorization number, a mismatched date of service, a modifier omitted, or a coordination of benefits question nobody answered. Those need correcting and resubmitting inside the timely filing window, and that is administrative work. Honest Taskers places staff who work inside your practice management system on it: reading and recording the denial reason, correcting what can be corrected and resubmitting, assembling the records and documentation an appeal needs so your biller or clinician only has to review and sign, tracking reconsiderations and their deadlines, and flagging the denials that need a real appeal argument. The pattern reporting matters as much as the individual fixes, because the same five reasons usually cause most of the volume. Staff are trained on HIPAA and data privacy under a dedicated compliance officer, work in your time zone, and a Business Associate Agreement is signed before anyone touches protected health information, with HIPAA compliance verified by Accountable. Rates run about $10 to $12.65 an hour by role, background, schedule, and location, with a two-week working trial on the first hire and 99.6% average monthly retention reported. See the virtual medical billing service for role detail.

    Limitation: staff assemble and track appeals rather than writing the clinical or policy argument, which stays with your billers and clinicians, and the firm names no AAPC or AHIMA credential and no SOC 2 or ISO certification.

    2. Plutus Health

    Best for: practices facing complex denials, underpayments, or out-of-network disputes that need a formal process.

    Pricing: Not publicly listedLocation: Dallas TX; three delivery centersModel: Outsourced service plus AI agentsCompliance: SOC 2 Type II

    Plutus Health is the deepest resolution capability here and the only firm naming No Surprises Act independent dispute resolution, which is the formal route for out-of-network payment disputes and a process most billing firms will not take on. Alongside it sit denial management, complex claims, insurance discovery for patients whose coverage was never identified, diagnosis related grouping validation, medical coding audit, and inpatient and HCC coding, which together mean it can determine whether a denial reflects a coding error, a coverage gap, or a payer being wrong. It reports more than 9,000 providers across 40 or more US states, $1.7 billion in annual claims, $1 billion in annual collections, 1,600 agents and 25 AI agents in production, from a Dallas headquarters with three global delivery centers, and states HIPAA and SOC 2 Type II with AAPC-certified audits against a 99.2% accuracy threshold.

    Limitation: no pricing is published, the delivery centers are not named, and individual coder credentials are not listed, so establish who handles your disputes and what the dispute process costs.

    3. AGS Health

    Best for: health systems that want denial resolution joined up with the coding and documentation causing the denials.

    Pricing: Not publicly listedLocation: HQ Washington DC; delivery ChennaiModel: Outsourced serviceClients: Banner Health, Baylor Scott & White

    AGS Health names denials alongside coding, clinical documentation improvement, claims, accounts receivable, prior authorization, and provider enrollment, and for resolution that combination is the point. A denial resolved without fixing the coding or documentation behind it comes back next month under a different claim number, and a firm that holds both sides can close the loop. Its named clients include Banner Health and Baylor Scott & White, and it operates from Washington DC with a delivery center in Chennai, India. Clinical documentation improvement in particular is what distinguishes it from the pure billing firms here.

    Limitation: it is built for health systems rather than practices, publishes no pricing, and names only a Cybersecurity Transparent Designation from 2023 rather than an audited standard.

    4. Transcure

    Best for: practices that want resolution work paid for out of what it recovers.

    Pricing: 3% to 5% of monthly collectionsLocation: Texas, New Jersey, FloridaModel: Percentage of collectionsScale: 1,100+ certified billers and coders

    Transcure publishes 3% to 5% of monthly collections, and on denial resolution specifically a contingent fee is the cleanest incentive available: the firm is paid for claims it turns around and not for claims it files and forgets. Its work covers billing, coding, audits, MIPS, eligibility, and credentialing across more than 40 specialties, with more than 1,100 certified billers and coders and offices in Texas, New Jersey, and Florida, which means US-hours availability for payer calls. It states ISO 27001 and AAPC-certified billers and coders, both company-reported, and the coding certification matters here because a large share of resolvable denials are coding disputes.

    Limitation: percentage pricing rises as your revenue does, and the engagement covers the whole revenue cycle rather than only the denial queue.

    5. Waystar

    Best for: organizations that want to stop denials happening rather than resolve them faster.

    Pricing: Not publicly listedLocation: Not publicly listedModel: Software platformCompliance: HIPAA, SOC 2, HITRUST, PCI-DSS

    Waystar is the prevention entry, and prevention beats resolution on cost every time. Its Denial and Appeal Management and Recoupment Manager modules handle the back end, but the interesting products sit upstream: prebill anomaly detection and diagnosis related grouping anomaly detection catch the claim before it goes out, and charge integrity and utilization management address the causes. It reports more than a million providers and 60% of the US patient population across settings from physician practices and ambulatory surgery centers to billing services, laboratories, home health and hospice, skilled nursing, and health systems, with HIPAA, SOC 2, HITRUST, and PCI-DSS compliance, the strongest position on this list.

    Limitation: it is software, so somebody on your team still writes every appeal and works every queue, and no pricing is published.

    6. Neolytix

    Best for: small and mid-sized practices that suspect the payer contract, not the claim, is the real problem.

    Pricing: Not publicly listedLocation: HQ ChicagoModel: Outsourced service plus staffingCompliance: ISO 27001 certified

    Neolytix covers denials inside its revenue cycle work, and adds two things that matter for chronic resolution problems: coding audit, which finds whether your own coding is generating the denials, and payer contract work alongside credentialing, provider enrollment, and licensing. If one payer produces most of your denials, renegotiating or correcting the contract and enrollment position is a more durable fix than appealing individually. It reports serving more than 270 organizations across 31 specialties in 40 states from Chicago, with explicit small-practice and mid-market tiers, and it is ISO 27001 certified with HIPAA compliance stated.

    Limitation: claims resolution is not a named service line and no pricing is published, so the scope and cost both take a quote.

    7. Staffingly

    Best for: practices wanting resolution capacity at a published flat weekly rate with audited security certifications.

    Pricing: $399/wk at 45 hours, $349 at 5+, $299 at 10+Location: India, Pakistan, BangladeshModel: Placed remote staff, flat weeklyCompliance: SOC 2 Type II, ISO 27001

    Staffingly is the cost-led capacity option, at a published $399 a week per person for 45 hours, dropping to $349 at five or more people and $299 at ten or more, which makes the arithmetic against an hourly rate straightforward. It places remote staff for billing, coding, prior authorization, and documentation work, and its documented security position is the strongest on this list: SOC 2 Type II, ISO/IEC 27001:2022, a signed Business Associate Agreement, and a $5 million errors and omissions and cyber policy, all company-reported. Delivery is from company-stated secured facilities in India, Pakistan, and Bangladesh.

    Limitation: its workflow is AI-assisted with a person verifying output rather than fully human, it names no coding credentials, and offshore hours need arranging around payer availability.

    Should denials be resolved in-house by a specialist, outsourced, or prevented?

    Prevent first, because it is the cheapest of the three by a wide margin: a claim that goes out clean costs nothing to resolve, and prebill and coding anomaly detection are aimed at exactly that. Then resolve in-house when most of your denials are correctable errors, since correcting and resubmitting is administrative work and a medical records specialist earned about $51,140 a year, roughly $24.59 an hour before benefits, according to the U.S. Bureau of Labor Statistics May 2025 wage data for medical records specialists, against roughly $10 to $13 an hour or $399 a week flat for placed remote staff. Outsource on contingency when you have a real backlog of appealable denials and would rather pay a share of recovery than carry the labor. Escalate to a specialist when the dispute is genuinely adversarial: underpayments, out-of-network balances, and No Surprises Act cases need somebody who runs that process regularly. The mistake worth avoiding is treating all denials as one queue, because the correctable ones need speed and the disputable ones need argument, and a team optimised for one is bad at the other. For the administrative scope, see tasks to outsource to a virtual medical assistant.

    What are the risks of outsourcing to a claims resolution specialist?

    Resolution involves representing your practice to a payer, which raises the stakes beyond ordinary queue work.

    • Appeal deadlines, which are shorter than filing deadlines. Ask for the report showing appeal windows by payer and days remaining.
    • Who signs the clinical argument. An appeal citing medical necessity needs a clinician behind it. Write down who reviews and signs.
    • Root cause reporting. Insist on denial reasons aggregated by payer and code, or you will resolve the same denial forever.
    • Write-off and adjustment limits. Set the threshold in writing, because closing a claim by writing it off looks identical to resolving it in a report.
    • Compliance evidence. Positions here range from HITRUST and SOC 2 Type II down to a single named designation. Get the BAA first.

    How is a claims resolution specialist priced?

    Three published shapes and four quotes. Percentage of collections: Transcure at 3% to 5% of monthly collections, the contingent model. Flat weekly: Staffingly at $399 per person for 45 hours, $349 at five or more, $299 at ten or more. Hourly: Honest Taskers at $10.00 to $12.65 depending on role, background, schedule, and location. Plutus Health, AGS Health, Neolytix, and Waystar are quote-only, and specialist dispute work such as independent dispute resolution is commonly priced per case in this market, though no firm here publishes a figure. Compare on recovery per dollar spent, split between correctable denials and appealable ones, because the two have different economics: correctable denials reward cheap volume, and appealable denials reward skill. Rates were checked August 2026 and change often. For staffing rate context, see how much a virtual medical assistant costs in 2026.

    What should you look for in a claims resolution specialist?

    Resolution depth, appeal capability, root cause reporting, and dispute experience.

    • Depth, stated plainly. Correction and resubmission, appeal writing, or formal dispute. Buy the depth your denials need.
    • Appeal deadline tracking. Ask to see the report before signing.
    • Root cause analytics. Require denial reasons aggregated by payer, code, and provider.
    • Dispute experience. If out-of-network balances matter to you, ask directly about independent dispute resolution.
    • Named security standard. SOC 2 Type II, ISO 27001, or HITRUST rather than a self-described designation.

    How do you hand denial resolution to a specialist?

    Start by sorting your denials into correctable and arguable, because they are two different purchases.

    1. Pull three months of denials and group them by reason code, payer, and dollar value.
    2. Separate the correctable errors from the ones needing a clinical or policy argument.
    3. Staff the correctable queue and set a resubmission turnaround target in days.
    4. Route the arguable denials to a firm with appeal and dispute capability, and agree who signs the clinical argument.
    5. Get the Business Associate Agreement, system access, and a written adjustment threshold, then re-measure denial rate by reason after ninety days.

    For the hiring route on the staffing option, read how to hire a virtual medical assistant.

    Methodology and sources

    We read each company's own website in August 2026, recording what resolution work is performed, what credentials or certifications are stated, published pricing, purchase model, and named compliance. Wage context is from the U.S. Bureau of Labor Statistics May 2025 Occupational Employment and Wage Statistics for medical records specialists. Appeal rights and timelines are set by the Centers for Medicare and Medicaid Services for Medicare and by contract for commercial payers, and the independent dispute resolution process is established under the No Surprises Act. Where a company didn't publish a fact, we marked it "not publicly listed"; accuracy, volume and collection figures are labeled company-reported and were not independently audited.

    Related denial management guides

    If most of your denials are correctable errors, the fix is speed and pattern reporting rather than appeal skill. Our explainer on what a virtual medical assistant is covers what a remote hire can own in a denial queue, and where the boundary sits before an appeal needs a clinician or a certified coder.

    Speak with Honest Taskers about staffing your denial resolution.

    Frequently Asked Questions
    Are claims resolution specialists HIPAA compliant?▼
    Can a claims resolution specialist work in my EHR and billing system?▼
    What tasks does a claims resolution specialist handle?▼
    Can a claims resolution specialist reduce denials?▼
    How does Honest Taskers staff claims resolution specialists?▼
    How fast can you hire a claims resolution specialist?▼
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