Case study
How a Physical Therapy Practice Reduced Staffing Costs by 80% While Scaling with GlobalSquirrels
A US-based physical therapy practice needed experienced remote healthcare professionals to support medical billing, insurance authorizations, benefits verification, collections, and administrative operations. The practice partnered with Global Squirrels to hire seven remote healthcare specialists from India and the Philippines. Global Squirrels handled sourcing, screening, onboarding, payroll, and ongoing support, reducing staffing costs by approximately 80% while helping the practice scale its back-office operations efficiently.
Executive summary: Scaling a physical therapy team with remote staff
A multi-location physical therapy practice in the United States needed experienced administrative staff to support insurance authorizations, benefits verification, medical billing, and collections.
Hiring these positions locally was expensive. According to the practice owner, comparable US-based staff could cost approximately $5,000 per person, while remote professionals hired through Global Squirrels cost roughly $700 to $800 per person.
The practice began using Global Squirrels to identify and hire experienced remote healthcare support professionals. Over time, the relationship expanded to seven team members supporting different parts of the practice’s administrative operations.
Global Squirrels handled candidate sourcing, screening, hiring coordination, payroll administration, and ongoing support. This allowed the client to expand its back-office team without having to independently manage international payroll processes.
The client reported approximately 80% lower staffing costs compared with hiring similar roles locally, while maintaining the experience and responsiveness required for patient-facing healthcare administration.
The engagement also demonstrated how the recruitment process handled unexpected hiring challenges. When one candidate accepted an offer but later withdrew after requesting higher compensation, Global Squirrels provided a full refund, reopened the search, strengthened candidate confirmation, and expanded sourcing across India and the Philippines.
Today, the physical therapy practice has seven Global Squirrels hires and has referred two other healthcare business owners who subsequently hired through the platform.
Key results
7 remote staff hired
Supporting medical billing, authorizations, benefits verification, and collections.
Approximately 80% lower staffing costs
The client reported spending roughly $700 to $800 per remote team member compared with approximately $5,000 for similar local staffing.
2 successful client referrals
Two healthcare colleagues referred by the client also went on to hire through Global Squirrels.
About client: US physical therapy practice with 7 remote staff
The practice needed more than inexpensive administrative support. Employees had to understand healthcare workflows, communicate with insurance providers, work during US office hours, and become productive with relatively limited training.
The challenge: Hiring healthcare support staff without high local costs
High costs for US-based administrative healthcare staff
The most significant challenge was cost.
The practice owner estimated that hiring comparable staff locally could cost approximately $5,000 per person. As the number of physical therapy locations and administrative responsibilities increased, maintaining a larger local back-office team would significantly increase monthly payroll expenses.
The practice needed an alternative that allowed it to add capacity while preserving its operating budget.
Multiple specialized healthcare workflows
The practice was not simply looking for general virtual assistants.
Remote employees needed to support functions such as:
- Insurance authorization requests
- Patient benefits verification
- Medical billing
- Payment collections
- Insurance company communication
These responsibilities require familiarity with healthcare administration and the ability to work accurately within established processes.
Hiring candidates without relevant experience would increase training time and create additional work for the existing team.
US working hours for international employees
Because the employees were located internationally, working hours needed careful planning.
The physical therapy offices required team members who could operate during US business hours, particularly for tasks involving live calls with insurance companies.
The client was willing to adjust schedules when practical, but candidates needed to understand the expected shift before accepting the position.
Need for rapid hiring
When administrative volume increased, the practice needed candidates quickly.
The client reported that Global Squirrels typically presented candidates within a week and, for urgent requirements, sometimes within a few days.
That responsiveness was important because unfilled administrative roles could place more pressure on the existing billing, authorization, and office teams.
Managing an unexpected candidate withdrawal
One hiring cycle also presented a real recruitment challenge.
A candidate accepted an offer but did not start the position. The candidate later requested higher compensation after receiving another employment opportunity.
Rather than renegotiating the accepted offer, the client and Global Squirrels agreed to restart the search.
Global Squirrels issued a full refund and committed to additional candidate confirmation before future offers were finalized.
This experience helped refine the recruitment process and demonstrated the importance of confirming compensation expectations, shift availability, competing offers, and genuine joining intent before onboarding.
The solution: Remote healthcare staffing with payroll support
Global Squirrels created a repeatable remote hiring process that allowed the physical therapy practice to source experienced administrative healthcare professionals while keeping final hiring decisions with the client.
Recruiting candidates with relevant healthcare experience
Global Squirrels focused on candidates with experience related to medical billing, benefits verification, insurance authorization, collections, and healthcare administration.
Candidate experience was considered when determining compensation rather than placing every candidate into a single fixed salary structure.
This gave the client flexibility to choose between more experienced candidates who could become productive quickly and candidates who required additional training but fit a lower budget.
Expanding the talent search
For new requirements, Global Squirrels could recruit candidates from multiple international talent markets.
India remained an important source of healthcare administrative talent, while the Philippines was added as another option when the client required a broader candidate pool.
This provided greater flexibility when hiring urgent or specialized positions.
Screening candidates before client interviews
Global Squirrels handled the initial recruitment work before candidates were presented to the physical therapy practice.
The screening process focused on areas such as:
- Relevant healthcare experience
- Previous billing or authorization responsibilities
- Communication ability
- Compensation expectations
- Shift availability
- Availability to start
- Interest in the role
Following the candidate withdrawal, additional emphasis was placed on reconfirming salary expectations and willingness to work the required schedule.
Payroll and administrative support
One of the most valuable parts of the engagement was payroll administration.
Instead of the practice owner managing international payments individually, the client funded Global Squirrels and the platform coordinated employee payments.
If a banking or payroll question arose, Global Squirrels handled the issue directly with the worker.
This reduced the amount of time the practice owner spent answering payroll questions or managing international payment logistics.
US business hour alignment
Remote employees were scheduled to support the physical therapy offices during relevant US working hours.
This was particularly important for team members making calls to insurers, verifying patient benefits, or completing authorization-related tasks.
Working-hour alignment allowed the remote team to collaborate with US staff in real time rather than operating as a disconnected overnight back-office function.
How the hiring process runs: From role brief to onboarding
Step 1: Define the position
The physical therapy practice identifies the role it needs to fill and provides Global Squirrels with information about responsibilities, experience requirements, schedule, and expected compensation.
For this client, common requirements included medical billing, authorizations, benefits verification, collections, and insurance communication.
Step 2: Confirm shift requirements
Because international employees may work outside normal daytime hours in their home countries, the expected US schedule is communicated before candidates progress through the process.
For roles involving insurer calls, availability during US office hours is particularly important.
Step 3: Source healthcare candidates
Global Squirrels searches its available talent markets for professionals whose healthcare experience matches the position.
India and the Philippines can both be used depending on candidate availability and role requirements.
Step 4: Screen and reconfirm candidates
Candidates are evaluated for experience, communication skills, availability, compensation expectations, and schedule compatibility.
For this account, the recruitment team also strengthened pre-offer confirmation after experiencing a candidate withdrawal.
Step 5: Present qualified candidates
The client receives screened profiles rather than having to search through a large volume of applicants independently.
The practice owner can then determine which candidates should move forward.
Step 6: Conduct client interviews
The client interviews shortlisted candidates and assesses practical fit for the physical therapy practice.
Final candidate selection remains entirely with the client.
Step 7: Confirm the offer and joining intent
Compensation, schedule, start date, and role expectations are reconfirmed before onboarding.
This additional confirmation helps reduce the likelihood of candidates withdrawing because of compensation or scheduling misunderstandings.
Step 8: Complete onboarding and training
Once hired, the remote professional completes onboarding and begins learning the practice’s specific workflows.
According to the client, experienced candidates generally required only a few days of basic training before beginning their regular responsibilities.
Step 9: Global Squirrels manages payroll administration
Global Squirrels coordinates payroll for the remote employees and handles related payment questions.
The practice owner can therefore focus on employee performance and business operations rather than international payroll administration.
Step 10: Add more staff as the practice grows
Once the model proved effective, the practice continued using Global Squirrels across additional administrative functions.
This ultimately resulted in a seven-person remote team.
Results: Around 80% lower staffing costs & 7 successful hires
7 remote professionals added to the team
The physical therapy practice expanded its international workforce to seven employees hired through Global Squirrels.
These professionals support important administrative functions including medical billing, insurance authorizations, benefits verification, and collections.
Approximately 80% lower staffing costs
The practice owner reported substantial savings compared with hiring similar employees locally.
He estimated that comparable US staffing could cost approximately $5,000 per person, compared with roughly $700 to $800 for members of his remote team.
Based on his overall experience, the client described the staffing cost reduction as approximately 80%.
For a growing physical therapy practice, these savings made it possible to expand administrative capacity without increasing payroll at the same rate.
Faster access to candidates
The client reported normally receiving candidates within approximately one week.
For urgent requirements, candidate profiles could sometimes be presented within only a few days.
Fast sourcing helped the practice respond when administrative workloads increased.
Shorter onboarding for experienced candidates
Candidates arrived with relevant healthcare administrative experience.
The client reported that new hires generally required only a few days of basic training before becoming familiar with their responsibilities.
This reduced the amount of internal time required to train each employee from the beginning.
Less payroll administration
With Global Squirrels handling remote employee payroll administration, the practice owner did not need to individually coordinate payments or resolve routine payroll and banking questions.
This removed an ongoing administrative responsibility from the client’s workload.
Real-time collaboration with the US team
Remote employees worked schedules aligned with the physical therapy offices.
This enabled staff responsible for authorizations, insurance verification, and other communication-heavy tasks to operate while US insurers and office teams were available.
A recruitment issue resolved without additional financial loss
When a selected candidate withdrew before starting, Global Squirrels provided the client with a full refund and restarted recruitment.
The process was also adjusted to include stronger confirmation of candidate commitment, compensation expectations, and shift availability.
Rather than ending the relationship, the way the issue was handled strengthened the client’s confidence in continuing to hire through Global Squirrels.
2 successful referrals to other healthcare businesses
Client satisfaction extended beyond the physical therapy practice itself.
The owner recommended Global Squirrels to two colleagues.
Both subsequently used the service to hire employees and reported positive experiences, providing an additional indicator of customer confidence in the recruitment model.
Testimonial: Building a reliable remote healthcare team
Why physical therapy practices choose Global Squirrels
Physical therapy practices depend on more than clinicians.
Behind every patient visit is a significant amount of administrative work involving insurance verification, prior authorizations, billing, collections, appointment coordination, and payer communication.
As a practice grows, these responsibilities can require additional staff long before the organization is ready to absorb the cost of a larger local administrative team.
Global Squirrels provides an alternative.
Hire healthcare-experienced remote staff
Practices can recruit professionals with experience in medical billing, insurance authorizations, benefits verification, collections, and other healthcare administrative workflows.
Reduce staffing costs
Access to international talent can help healthcare businesses expand administrative capacity at a lower cost than equivalent local hiring, depending on the role, experience level, country, compensation, and employment requirements.
Match compensation to experience
Clients can evaluate candidates at different experience and compensation levels rather than relying on a single fixed rate for every worker.
Maintain control over hiring
Global Squirrels manages sourcing and screening, but the client decides whom to interview and hire.
Align remote teams with US working hours
Candidates can be screened for their ability to support schedules that overlap with US office hours, which is particularly important for insurance and patient administration roles.
Simplify international payroll administration
Global Squirrels handles the agreed payroll and employment administration so healthcare practice owners do not have to coordinate each international worker independently.
Scale one role at a time
Practices can begin with a specific administrative function and add additional employees as the operating model proves successful.
For this physical therapy practice, that approach grew into a seven-person remote team supporting several essential back-office functions.
Build a skilled remote healthcare team while keeping staffing costs under control.
Hire dedicated remote medical billing, insurance verification, and administrative healthcare professionals with transparent pricing and a structured recruitment process.