Twenty-five productive seats, seven roles over them

The recommended composition for a 25-seat pod. It can be varied by agreement as the specialty mix shifts, but the certified-coder proportion is a floor, not a target.

Billable seat mix

Role	Seats	Certification requirement	Billable
Medical coder — outpatient and specialty	10	AAPC CPC or AHIMA CCS-P, current	Yes
AR analyst — denials and follow-up	8	Preferred: CPB or equivalent experience	Yes
Charge entry and payment posting executive	4	Trained in-process; no external certification required	Yes
Eligibility and prior-authorisation executive	3	Trained in-process	Yes
Total productive seats	25	—	Billed at $1,300 each

On the certified-coder floor. Ten of twenty-five is the minimum, not the recommendation. Partners who plan to have experienced non-certified staff act as coders do not pass the certification gate and lose the wave. Credentials are checked against the issuing body's register at onboarding and annually.

Overlay

Management and support — your cost, already inside the rate

These roles are not separately billable, and they are not optional. A partner who runs this process with one team leader and no dedicated auditor will fail the first calibration.

Role	Count at 25 seats	Ratio standard	Purpose
Team leader	2	1 per 15 agents	Daily allocation, production tracking, first-level escalation
Quality analyst / internal auditor	1	1 per 30 agents	Pre-bill audit sampling, error trending, calibration with Akontec
Trainer	1	1 per 50 during ramp	Induction, specialty modules, refresher on payer rule changes
Delivery manager	1	1 per engagement	Owns the service level, the client review and the recovery plan
MIS and reporting analyst	1	1 per engagement	Daily production file, ageing movement, monthly pack
Compliance and information security officer	0.5	Shared, named	Access control, incident handling, audit evidence

Hire the supervision before you hire the twenty-fifth agent. On this process the auditor is not overhead — the auditor is the product.

Rostering

Shift pattern

Coding, charge entry and posting are asynchronous and can be run on a single India-day shift. Eligibility verification and AR follow-up need an overlap with United States business hours, because payer portals are busiest and most reliable then, and because a same-day query to the client's onshore team is worth more than a next-day one.

Shift	Seats	Functions	Coverage
Primary — India day	16	Coding, charge entry, payment posting, claim scrubbing	Aligned to the India working day
Overlap — US business hours	9	Eligibility, prior authorisation, AR follow-up, denial appeals	Approx. 09:00–18:00 US Eastern
Weekend cover	By exception	Backlog clearance and month-end posting only	Agreed in advance, not standing

Night-shift allowances, transport and statutory obligations for the overlap shift are the service provider's cost and are reflected in the provider economics.

Recruitment

Hiring profile

The profiles below are what the assessment pack tests for. Unbranded job descriptions for each role accompany this proposal, so that you can advertise on your own letterhead — they carry no client name and no Akontec name.

Role	Experience	Non-negotiable	Nice to have
Medical coder	2–5 years US outpatient coding	Current AAPC or AHIMA credential; passes the Akontec coding test at 96% or above	Multi-specialty exposure; encoder software experience
AR analyst	1–4 years US AR or denial management	Reads and interprets remark codes without prompting; written English at business standard	Appeal-writing experience; payer portal familiarity
Charge entry / posting	0–2 years, back office	Keyboard accuracy above 99% on the entry test; attention to detail	Prior healthcare exposure
Eligibility executive	1–3 years	Comfortable navigating multiple payer portals; comprehends benefit language	Prior authorisation experience

Attrition

Plan for 18–24% on non-certified roles

Materially lower on certified coders. A ten per cent trained bench is expected from the end of wave two — not idle headcount, but cross-trained staff on adjacent work who can be moved inside a day.

Backfill

Five business days, and the seat keeps billing for three

A seat vacated is billed for up to three business days while backfill is arranged; beyond five it is not billed until refilled. That clause protects the client from paying for empty chairs and protects you from being penalised for a resignation you could not prevent.

Next step

The seat mix is a condition, not a suggestion.

The management overlay and the certified-coder floor are both checked at the readiness audit and again at each quarterly review.

Read the commercial terms See the onboarding plan