No career development whatsoever. If you don't speak Spanish, work elsewhere than South Americas, there is no room for your career development, for sure. You are supposed to be doing exactly same things in 5 years, in 10 years... with the same salary.
Billing department is an absolute nightmare. I don't know what is going on there, but they don't pay the bills on time, and many hospitals now deny our clients. Seriously, they delay payment sometimes more than a year. If it keeps this way, nobody would ever want to work with this company.