In 2018, when Jose Herrera, Alex Ross, and Jared Karson started Horatio, healthcare wasn’t the plan. The three Columbia Business School classmates were focused on a more general problem: why customer experience, especially for fast-growing tech companies, was still powered by brittle tools, undertrained teams, and outsourcing models that collapsed at scale.
Horatio grew fast by rejecting that status quo. Instead of treating support as a cost center, the founders built a CX operation around highly trained, nearshore teams in Latin America, modern SaaS tooling, and a culture that treated service quality as a product. By 2024, that approach had nearly doubled the company’s workforce to close to 3,000 employees and landed Horatio on Inc.’s 2025 list of fastest-growing private companies. But scaling CX for consumer apps and SaaS platforms was only a warm-up.
Healthcare, Herrera says, was always the hardest—and most personal—problem. Raised by a pediatrician father and a biotechnician mother, he grew up watching care delivery strain under administrative complexity. As digital health companies exploded over the last decade, that same tension reappeared in a more technical form: fragmented systems, staffing shortages, regulatory landmines, and patient experiences that broke down just when trust mattered most.
Horatio itself has demonstrated strong growth as a modern customer experience and outsourcing partner for digital-native brands. In 2024, the company nearly doubled its global workforce, growing from approximately 1,600 to nearly 3,000 employees across the U.S. and Latin America to meet rising demand in regulated and high-growth sectors. This momentum earned Horatio a spot on Inc. Magazine’s 2025 Inc. 5000 list of America’s fastest-growing private companies (No. 1,168), along with multiple regional growth recognitions, including No. 27 on the 2025 Inc. Regionals: Northeast ranking.
This week, Horatio is making its clearest bet yet with the launch of HoratioHX, a healthcare-specific experience platform designed to operate where human empathy and compliance-heavy workflows collide.
Unlike traditional healthcare BPOs, HoratioHX is built as an operational layer, not a staffing stopgap. It combines healthcare-trained teams with AI-assisted triage, predictive staffing, sentiment analysis, and automation across patient support, scheduling, billing, insurance verification, and revenue cycle management. Compliance isn’t bolted on—it’s foundational, with HIPAA-aligned workflows and ISO/IEC 27001–certified security baked into day-to-day operations.
Alex Ross, Horatio’s COO, has spent years turning what is typically a people-scaling problem into a systems problem. That operational discipline is what allowed Horatio to enter regulated industries without sacrificing speed. Meanwhile, CFO and co-founder Jared Karson helped engineer a growth model that could absorb complexity—new geographies, new verticals, new risk profiles—without breaking unit economics.
The result is a platform designed for modern healthcare companies that already have software, already have clinicians, but lack the operational glue to scale cleanly across states, services, and patient populations.
HoratioHX is supporting telehealth platforms, diagnostics companies, behavioral health providers, and women’s health startups. For the founders, it represents a full-circle moment: applying the lessons of hypergrowth CX to an industry where mistakes are costly and trust is non-negotiable.
