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I'll add my 5 cents to your 2 for 7 cents sm

Posted By: Flame me if you will on 2008-12-24
In Reply to: I am amazed by how many ungrateful MTs there are - my 2 cents


I know an MT who sits on her laurels and whines about no work and only getting 9 cpl after 5 whole years of experience. She can type 3 specialties, won't touch an ESL, goofs off when there is work and whines when there is not. I have tried to help, but it is quite plain to me she doesn't want that help.

I have about 3 times the experience of the above MT. The only specialty I have not done is pathology. I have literally done everything else. I know the BOS 2 like the back of my hand and I have outstanding accuracy scores (even if I can't type straight here). I work as an employee and make a base rate of 8.5 cpl, which I never get because I always have some of the different incentives offered. I regularly turn that 8.5 cpl into $25 an hour and at my PT job where I get 10 cpl and faster software, I can turn that into $32.50 an hour.

I have heard, more times than I can count from other MTs that they wish they could have my income. I can tell they why they don't. It is called hang out to complain on a message board like MTStars. It is doing everything, BUT your work on your shift. It is your lack of a willingness to learn new things, even if they slow you down some. This very year, recently in fact, I was put on straight cardiology procedure notes and I didn't worry for a second that I would suffer financially. I AM FLEXIBLE and that, in a nutshell, is why most MTs will not succeed.

A long time ago I realized that if I want more money, I was going to have to work SMART, not hard. In my 15 years, I now make 5 times what I did my first year and at the same exact line rate I had then! I spend less time working to achieve that these days. So no, I can't agree with your sky is falling routine.

Most of you...your attitudes suck. If I had to have you on site as my employees, you would not last 15 minutes. The first time I heard you at the water cooler whining about your pay, I'd fire your fanny so fast it would make your head SWIM. I have eyes in the back of my head too, so when you started making that stink face you are making right now, I'd have sacked you for that, on the spot, no warning and no day's pay. The ONLY reason you all get away with this is that you THINK no one who knows you is watching and that your respective contract holders can't figure out who you are.

By and large, I can't tolerate other MTs as friends. I find them lazy, self-absorbed whiners and complainers with some the worst negative attitudes I have EVER seen! If you hate MT so very much GO GET A JOB DOING SOMETHING ELSE. I can tell you, your bad attitude, your tendency to complain, whine, witch (with a capital B), moan and ALWAYS see the most negative side of everything...THAT crap will follow you to that new career and it won't be any better than this one. You have issues and I really think they are issues for a good therapist. They are called personality disorders and many of you have them in multiples and in spades!

I think you should be completely and utterly ashamed of yourselves. Too many people are out of work, homeless, and starving this Christmas to be so opinionated and selfish.

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What is average? 7 cents, 8 cents, 9 cents? 65-character?
I also work for 8 cents a line. I left a job typing OPs for 10-11 cents sm
to take a clinic job. I made an average of $17-18 an hour with OPs, now make $16-17 an hour, but the work is easier on me. I do not call that poor pay. I type 200+ lines an hour. True, it isn't the $26-27 an hour I was making 10 years ago at a hospital, but that's gone for good. I have excellent skills, make better than 99% on QA at any company I have worked for, and some of those have been very demanding.

I'm afraid the people that are expecting to make $20-30 an hour in MT are going to be disappointed. A few can still make that amount, but for the average good transcriptionist, the pay is much more likely to run $15-20. Benefits are pretty much gone. However, I feel that what I'm making is considerably above what I could make in another field, unless I decide to teach, which I will not do. Still, I make more than I would at Walmart or Burger King, or even a secretarial job. It's my choice. Good luck to you.
The mentoring program does not pay 8-1/2 cents per line. Believe it is like 6 cents.
the pay is 10 cents a line and 11 on weekends, more than you'll at most other places
I'd say 55 cents a word is a moneymaker, you'll get rich!

Whether an MT is new or an editor, 4 cents a line is deeply insulting, and 9 cents per line isn't really too much better. You know, I understand that most of these MT companies want to save money, but most of them don't seem to want to pay what an MT's time and skills are really worth. Why not pay an MT who has been in the field for 7-10 years or more 15 or 20 cents per line? At least I might consider working for one of these companies at home if I were to be paid that much straight off the bat for having 12 years' experience, but I guess that would be too much like right...
Do they still pay you 5 cents a line and 2 cents if you send anything to QA?
I have a problem with 7 cents and 8 cents a line because
...when I started 15 years ago, my very first MT job started me out at 8 cents a gross line, then went to 9 cents a gross line after only a year. I was SOOO happy and proud of myself for choosing a profession that paid so well - I imagined myself making a lot of $$ once I had 10 or 15 years experience behind me...

Well that never happened; in fact, it all went backwards, pay wise. The company I worked for back then sold out to a national, and of course the pay was cut, and 9 cents a gross line was never to be had again, at least not that I could find. I am considered living in poverty now. I started out great but have ended up very badly.

I think my own personal problem is that it's hard for me to let go the fact that I made good money just starting out and how everything I had ever learned about jobs, careers and pay was that the more experience and education you have in a particular field, the more your pay goes up as each year passes. Well my pay has been consistently taking a nosedive for at least a decade now. I actually have to work MORE to make at least as much as I did years ago, and it's killing me health-wise as far as my wrists, my legs, my neck, my back....

It also kills me that I'm going to have to accept 7 or 8 cents a 65-character line when I made so much more than that 15 years ago.

I suppose to someone who's just starting out, 7 or 8 cents would seem pretty good, though. Maybe that's why I haven't been able to land any jobs with my resume. They may not want me with my years of experience, probably want a newbie who will be more grateful about such low pay. I dunno.

I could just kick myself for wasting money on MT school those years ago when I could've spent it on a career that would actually LAST and where I'd be making great money after being in the same field for 15 years. There's just no reward to this business. None at all, IMO.

I would NOT recommend this field to anyone just getting started. To me, it's a dead field.

I'd have more freedom working at McDonalds (for a number of reasons), and, believe me, I've been considering taking a local job around my home for minimum wage. At least I'd have a consistent paycheck and would know exactly what I'm getting every 2 weeks, then build from there as far as another job or two.

Well anyway that's all. I really need a job. I'm going down, going under, and it's a shame because I do very good work and have all this experience but no one seems to want me, even the low-paying companies. Oh well.
Few cents here, few cents there stolen from you by
Their ad says 9 cents, not 10. nm
Just my 2 cents but here goes.
1. Schedule window. You know, like do 1000 lines on Monday between 7am and 7 pm. Something like that.
2. 8.5-9 cpl is fine with me, but a raise every 1 or 2 years as long as I have a good quality rating,95-100%.
3. Pay at least 1/2 (ideally 3/4) of the benefits. An HMO or PPO. 401 K and PTO are necessary for full time and nice for SE too.
4. I prefer employee status.
5. Direct deposit is nice but not a requirement.
6. Pay every other Friday would be good.
7. I would say what makes me stay (and who says I am right now) is QA and their attitude helping me with my work, training so I can learn different specialities to raise my rate, pay while training so I don't get penalized for learning something new and being more valuable to my company and answers to my equipment/work flow problems in a timely manner so I don't waste my time sitting on my hands waiting for work and/or equipment to be fixed. And the feeling that I am not so easy to replace, that I am appreciated. That's what I want for Christmas.
Want my 2 cents? -sm
I'd continue to look for another job and when you find a good one that pays what you'd like, give your notice and see if they offer you more then. They may or may not, but if I were you, I'd be ready to leave about now.

I've also found that if you don't want to take what they're offering, if you do manage to negotiate more money out of them, expect to get less work.
My 2 cents

Okay, some slamming going on here.  I do not find that there is dishonesty in line counting---have not had a problem in 4 years, paycheck is always accurate. 

Yes, they do QA you 100% at first.  If you are good at what you do, this will not be a problem either. 

As for running out of work, it happens with all nationals and especially this time of year; HOWEVER, it also makes a difference what shift and accounts you work on.  I find that splitting my shift (for family and carpal tunnel reasons), that I never have an issue with no work.  I will say that your manager will make a difference, some are good, some not so good.  It is obvious that they like you to be someone who can work independently, not needing constant contact with someone.  That is my style and it works for me, maybe not for you.  Good luck and welcome aboard! 

8.5 cents
My opinion is, without spaces it's not all that great. I have been checking around and have found 8 cents with spaces is about average.
4 cents
Chase told me they pay by the word.
My 2 cents
I worked there a few years in QA and the MT quality was horrendous. The U.S. editors were usually blamed for it in the end (even though we were only given a certain percentage to edit). We were often told that such-and-such client wasn't happy with the quality and they could lose the account so they put the pressure on the U.S. editors. Needless to say, I saw many clients come and go and personally know doctors who have used companies that offshore and it usually takes about six months until they realize their transcription (or coding) is completely beyond repair and they decide to go back to in-house or U.S. companies.

It still amazes me that so many clients are willing to send such confidential records overseas to save a few bucks. What they don't realize is - how much more EXTRA money they will need to spend in the end to fix the mess.
2 cents
Oh I know exactly how you feel, Medquist is the exact same way!!!
I'd do it for 15 cents or more.
I get 9 cents
I get 9 cents per line with MDI-FL.
8 cents

Depending on what the company offers, it is good.  I have been hired by Phoenix MedCom as an IC and will be making 8 cents with spaces, however, they do offer volume bonuses.


2 cents

Currently w/Diskriter and worked for MQ (been years) ...Personally, I'm much happier w/Diskriter. 

With MQ, I happened to have a terrible set up C-phone/lanier station...ugh.  Then, tech support/organization all that was terrible.  I had problems all the time....but plenty of work, if I could get to it....I wasn't even internet-based then ...that lets hope has changed. 

Diskriter technology, system, software, etc, is great!!!  I'm extremely impressed!  Communication is great!!  Everyone on our team is free to e-mail word/drug questions, which makes it really nice...

I don't know what MQ offers as benefits...Diskriter is good.  They are very nice, reliable, on-time paychecks, nice PTO, etc. 

The 1 and only complaint on Diskriter is that I have been moved from account to account to account and to account...It does get frustrating at times...but I think i've learned more w/them than my entire career!!!  I think they need to organize the work flow a bit better and amount of MTs on accounts...I believe some accounts are over flow which leads to unpredictable work volumes and thus running out of work...but never fail to have a 2nd, 3rd, 4th and probably 5th if I really desired to make less money and learn more!! LOL ...okay now I'm starting to vent a bit about it....I have to keep reminding myself I'm lucky just to have plenty of work and ...paid Down Time too, if you run out on all those....

I guess every company is going to have pros and cons....For me, I'm trying to adjust to all the accounts and be happy w/Diskriter because they are excellent in every other aspect...Good Luck to Ya!  

my 2 cents
Well I for one do not expect one or think it it owed to me but I do think it is a nice gesture. In every other job I have worked in other fields and in this one working at centers and hospitals I have always gotten something: a nice dinner, a bonus, some candy on my bday, a calendar, etc. I think it is reasonably to think it is nice to get something. It shows the christmas spirit and it shows me that just because I sit in my home I am still a part of the company because most of them probably have parties at the offices or for the office. For those of us working elsewhere it lets us know they did not forget us which is nice. I have a new company this year and I got a gift card for Thanksgiving and big giant box of candy for xmas. Biggest box of candy I have ever seen and to tell you the truth I had a bad stressful day off of shopping and such and that big ole box came and made me laugh and I needed that. That alone makes me thankful besides the fact that the candy was pretty good too. It is the thought and nice gesture that counts and matters.
My 2 cents
Part of the problem as I see it (and I owned my own business for 10 years a while back) is that the corporate management of medical transcription service often appears to be that there is little to negotiation between the hospital/doctors and the service. It's one of the reasons I cannot wait to get out of the business - or at least greatly reduce my time. There are so many gatekeepers between the scribe and the dictator now - and what is lost in this process is quality. Not to mention frustration: I have had to learn how to NOT think. Forget what I've taken 20 years to learn, just type it wrong because the service is unwilling or unable to explain what a scribe actually is trained to do...

I think that was more than 2 cents worth ... :)

My 2 cents on TTS

Great platform (escription), great account, great team leader, pay unpredictable (Friday's direct deposit received yesterday on Monday), pay many times short, nearly impossible to converse with owner who talks but does not listen.

My 2 cents
I have googled drugs and found them spelled the way the doctor spelled them but ultimately misspelled. Rxlist.com and prescribingreference.com are good resources for correct spelling and for finding drugs.

Second, their interoffice e-mail has been down. If you have that much of a gripe and are really concerned about it, call them on the phone. Ask to speak to the supervisor.

Ultimately, I think you are just plain unhappy with this company and will find any reason to find fault rather than resolution. I have had my rounds with QA with them and they have been accepting when I can show proof. Otherwise, I use QA as a learning tool. I have been with this particular company of which you speak since July of 2000 both as an employee and as an IC. Yes, I know which one it is as I have been following your postings - even the deleted one.

I wish you the best in your ventures with a new company. Every company is not a perfect fit for every one, so I hope you find your perfect fit.
My 2 cents
I know what she means by must make x or more, and I would strongly suggest you take very unhappy's advice - especially this part: Get a part-time job transcribing for any service who will hire you at home. Because you need the remote skills as well.

I personally believe you will have difficulty making 25K your first year with your limited experience, however, you can quickly gain knowledge of other specialities by studying, and then get hands-on experience in part time positions that will *not only* increase your experience, but also you'll make extra $ that you could save to pad any discrepancies when you finally do transition.

A word of caution: When you work at home, there is sometimes a different mindset with regard to pay (unless you are strickly an employee)... SOME MTSO's tie your payment to theirs (when they are paid by their clients) and that can mean a delay in paying you. Be careful about who you do work for - ask questions! *Strongly advise against* putting all eggs in one basket. Even great companies can lose accounts with no notice (for no apparent reason). If you are not diversified, you can lose your income overnight.

Good luck.
My two cents -
1. Currently flip back and forth between 4 different hospitals with 4 very different sets of specifics.
2. About 75%.
3. Not really.
4. What they offered me was VERY expensive for insurance. PTO is okay.
they pay 7.5 to 8 cents
its IC position.they hire mostly inexperience MT and very flexible and use EMDAT platform which I heard on this board is suppose to be good and very easy to use.
My 2 cents

If I were you in a similar situation, I think that I would feel as if I had been disrespected and manipulated.  However, this seems to be the way of the industry.  The MT's welfare is not the top priority.  It is likely that all of the details with regard to the actual job duties, benefits, etc., are NOT being shared.  The sad thing is that you may not find a better situation somewhere else.  In your favor, you have the fact that you are familiar with the dictators.  However, there is no guarantee that those dictators will be the only ones you will transcribe for at the new company.  Will the new situation be using the same platform that you have been using at your in-house job?  It is impossible to predict what the situation will be like, as it is amazing what little details some of these companies come up with. Again, you are several steps ahead if you are familiar with the dictators and the platform.  Consider the difficult scenario of going to work for a totally new group (now or after unemployment) and having to learn awful dictators, a new platform, specifications, etc.    Would unemployment even be available to you if you have turned down a job with the outsource company?  There might be a loophole there, as well, which might prevent you from getting the unemployment.    It sounds like, no matter how you look at it, you have been screwed over, but the degree of the screwing is what is in your control.  Seems to me that you and your fellow employees have some bargaining power if the doctors have demanded that you continue to transcribe their reports. 

Good luck.

My two cents
Very well said. I'm one of the people on the account that I suspect is being referred to in the previous post.  Yes, the new pay scale impacted me negatively but the previous poster's point that I had been getting paid for lines I probably shouldn't have is valid.  The biggest blow was to my ego since I thought I was perhaps a better Transcriptionist than I was!  The net of it is that I took a hit on this particular account but am making it up without much effort and still making the same good money I was previously.   My understanding is that most transcriptionists are coming out ahead with the new plan - it's just this particular account that was set up differently.  I love this account and would hate to lose it, so the extra effort is worth it.  The benefits are great and managment has bent over backwards to take my personal needs into consideration over the 4 years I've been there.  I look forward to many more years there, with particular interest in the 3 weeks vacation I will begin to receive when I hit 5 years!
Two more cents
P.S.  My QA scores are consistently 99% or 100%, falling to 98% occasionally.  Not hard to do at all if you know your stuff
11 cents for what?
which specialty?
My 2 cents.
They were very nice as long as I was at their beck and call.  When they left a voicemail message, I was to return their call immediately!!   This was all during the recruitment process, which was a red flag to me.  They became pretty nasty when I complained about their methods.  Also, the line pay was low and consisted of 95 characters.  When I converted to what it would be like given a 65-character line, it came to 4 cents.  So, I never worked for them.
My 2 cents
RADTRANS is a royal pain...

Page by Page - IF they were formally called LINE BY LINE I'd suggest you RUN.

Don't know the rest. Good luck!
My 2 cents

If you have called, I would wait 3 business days from that point and then call again.  Your persistence is not going to hurt anything and will only show how interested you are in the job. 

I had to be persistent.  I waited the 7-10 business days (or whatever it said on the website).  I then e-mailed, and they said they would track down my test.  Still after 3 more days I e-mailed again stating I had not applied any other places (yet) and was really hoping to hear back from them.  The next day they called. 

From an MT who has been around the block, this company is worth it.  Don't give up!  From the little knowledge I have, they have taken on some huge accounts (I work on one of them) and are really experiencing growing pains right now.  They are growing very fast and are just having a trouble keeping up, and the disorganization you are seeing in the hiring process is not indicative of what happens after you get hired.  These people are genuine and reasonable human beings in every aspect.  They are very good to their MTs.  I have had less stress on this job from day one than any other job I have ever worked. 

My 2 Cents
I was with MQ for 15+ years and now with Webmedx for 3. Much nicer people, much easier platform, but lack of work and new incentive not very helpful - will now be losing money. MQ had a lot less ESL docs to deal with, on my 5 accounts at Webmedx, they are all loaded. Do like the window but honestly if MQ was to change to that, I just might jump back. Good luck
Thanks for the 2 cents sm

I'm losing a lot of money with Medquist which is why I'm looking for something else.  I have a lot of terrible ESL's on ASR which takes me longer to edit than transcribe and I'm getting 3 cents less a line to do it.  I also would love incentive.  We currently don't have a weekly incentive program or a weekend bonus.

I currently don't run out of work a lot but I have up to 15 accounts that I'm working on which slows me down tremendously. 

I realize there are negatives with any company but hopefully there is something better out there!  I'm going to search until I find it, starting with Webmedx.  I plan to stay with Medquist part-time while trying out another company full time.

Thanks again for the input!

5-7 cents
They have got to be kidding !!!!! How stupid do they think we are?
My 2 cents
>wish you luck, but I'm afraid you will be sadly disappointed, perhaps not right away, but given enough time, if you go to work for them.<

This could be said of every transcription company out there. I don't work for focus, nor have I worked for focus, but I think you just have to take every comment with a grain of salt. Ive yet to see any one company not complained about by someone at some point on this forum. Just my 2 cents.
my 1.5 cents
Can't speak for Quig but feel he/she may have just meant quit before you are pushed to the point of exploding and then they can try to use that against you.

If I was in your position, I would immediately take another job (the best of the two offers) and cover yourself on the current job by either asking for a day or two off to see if the new job is a keeper, or taking a sick day...

if you can financially take the chance you can just quit.

What I have done in similar situation is to document what is currently owed to me, then offer a notice (it does not have to be 2 weeks) but ask for confirmation that you will be paid for anything earned over what is owed to the company. If they won't confirm *that* then it's time to go...

Have you considered asking them straight up why they are doing this to you all of a sudden? Sometimes the best approach is just being upfront. That said, I know all about games, so you are the best one to judge whether being direct would correct their behavior to you or just make it worse.

Good luck!
4 cents is 1/3 of what they are getting for doing nothing.
Here's my 2 cents (sm)

I became my own MTSO last year after getting tired of the BS of working for one.  First off, I highly recommend the book The Independent Medical Transcriptionist by Donna Avila-Weil.  I

Now to answer your questions as best I can:

1. How do you get the clients.

Network, send out mailers/letters, pound the pavement, apply for help wanted ads in the newspapers offering to outsource.

2. Are there certain types of docs that tend to prefer this situation rather than going to an MTSO?

Smaller clinics, independent doctors, speciality clinics, non-hospital settings

3. How do you determine what to charge?

Network with other independent MTs in your area, call doctor's offices and speak to the office manager who usually pays the bills, research.

4. How can someone get the dictation, type it and return to the doctor without having to pick it up and drop it off?

US Mail to a secure post office, digital via computer and uploading via encrypted email or FTP, courier, fedex

5. Without QA other than yourself, how does an IC handle blanks? Do doctor's offices tend to get upset with blanks?

Leave a blank if you absolutely cannot get the word, take time to research what you think you're hearing, ask for samples of the doctor's dictation when you sign the client, call the office staff and ask ... sometimes the office nurse is a great help.

6. Is there a particular software system that is better to use when you have your own IC service and want to get work over the Internet and return it over the Internet?

Microsoft word and express scribe, filezilla or cute FTP


Hope that helps some.  Good luck.  It's wonderful being your own boss!

My 2 cents

It seems to me that it is ethical and fair to treat a fair company fairly, and give 2 weeks' notice when resigning.

However, in the case of this company that is not paying on time, they have basically proven themselves to not qualify as a fair company; therefore, are not deserving of 2 weeks' notice.

I agree with the poster above; stop typing immediately.

In the meantime, don't be an overused, muddy doormat; find another house where they won't tramp on you.

my two cents - sm
In my 30+years of experience doing radiology, I have found that a majority of radiology platforms DO NOT count spaces, and the line counts from these are very difficult to get to add up, which is why I prefer per report pay. I can do over 200 reports a day and not hit 1600 lines, depending on length of reports that day. Some days are quick, short ones, others are long, involved invasive procedure ones. I personally would NOT want to HAVE to make 1600 lines on an unknown platform. It all depends on how they have it set up to count lines, and rad accounts are mostly in really old platforms. Not many have updated to newer systems. Just my two cents though.
My 2 cents

The way I see it, if they want to send the work to India or overhire MTs for my account, nothing that I do will make much difference.  As a matter of fact, in the past, I have worked 7 days a week on my account, but they went and overhired for it anyways.  So, I do my job to the best of my ability and, in the meantime, try to find other ways to make a living in order to prepare for the day when whatever happens..  As far as days off, they required a set schedule for me, so I work that schedule, and don't read their emails during my time off.  As for my phone, I do pay that bill myself, so I feel that I have the right to turn off the ringers, set the answering machine, and enjoy my days off.  My family and friends will call me on my cell phone, a number that I have not provided to my employer.  If they ever decide to offer me on-call pay, which I'm 99% sure they won't, we can negotiate.

So far, I've never received negative points on an evaluation or any real complaints for not being available during my time off.


My 2 cents

I like those figures that you cited in your post.  In the case of an employee that is required to work a set schedule, I think there should ALWAYS be an hourly pay rate PLUS cpl.  I'm thinking of something like $12/hour PLUS 5 cpl for standard reports and 3 cpl for edited reports, with a minimum line count per hour based on the availability of work and difficulty of the account.  Any line count per hour that is required in order to qualify for employee extra benefits should be waived if the work availability is slim.  I think this requirement would prevent employers from serious overhiring on accounts.  For IC status, of course, there would be no set schedule, no hourly rate, no minimum lines per hour requirement, but a higher line rate than for employees.

I also believe that the TAT requirement should be eased up.  As it is now, the doctors often wait until the last minute to dictate reports with a short TAT simply because the MTSOs rush to adhere to TAT.

There should be a mandatory training day for dictators.  When I worked in a hospital all doctors had to attend orientation and training on other hospital policies, but no training on dictation methods of operation.  All they received was a one sheet paper describing which buttons to push for what function on the dictation keypad, and even those instructions were quite vague.  It seems to me that a new dictator should be mentored until he or she gets it right.  It is time to treat doctors like human beings, not Gods.

3 cents is not enough, of course, but many pay more nm
2 cents.
I don't think anybody knows yet what Obama has in mind when he refers to electronic medical records. It could mean simply records stored in computer form rather than on paper to allow easy access from afar or it could mean point-and-click systems that would do away with dictation and transcription altogether.
my 2-cents
I just left TTS. I was left alone to work, but trying to get a response out of anyone higher up was horrible. Pay was always on time. I think the owner is bipolar or something, nice one day, hateful the next. They are going strictly to VR, which is why I left. I would have given it a shot but when I asked when it was happening I was told yesterday. Also, in the paperwork upon starting they gave a sheet outlining incentive pay, and then said it was old and didn't apply, after I typed my a*& off. Good luck if you go there ;)
Here is my 2 cents.....
The platform is good, the accounts are good, even the VR is good….. but by GOD.......their pay sucks and you can't depend on getting it when you want it.  So my advice is to ONLY work part-time and consider having another job with direct deposit, as working for TTD is strictly for pocket change.
My two cents... (sm)
The ad says that the per diem is (as per diems usually are) in ADDITION to the attractive salary. It's to cover your living expenses, meals, etc., since you're away from home.
I did this 2 decades ago in Saudi Arabia, worked for 9 months for a huge hospital that wanted to hire Americans (that sounds so funny now, it's sadly hilarious) and the per diem was on top of the salary, which was way more than I could make in the U.S. at the time. We lived for free in a furnished, dorm-style building attached to the hospital, and I got 3 months of paid vacation/holidays for working 9 months. The only drawback for me was that we weren't allowed to go out of the buildings unless we went with a group, because of fear of kidnapping since we were Americans, although I felt perfectly safe and did some sightseeing in escorted groups. Of course, in Alaska, you can probably come and go as you want. :) I'd do it again in a heart beat if I was still single, which I'm not. I would think of it as an adventure!