CAROLINA PEGUERO
Carteret
Summary
Experienced healthcare professional with over 7 years supporting patient care and administrative operations in fast-paced clinical environments, including surgical centers and specialized hematology/oncology offices. Skilled in managing high-volume inbound and outbound calls, coordinating complex appointment and surgical scheduling, and verifying insurance coverage with precision. Adept at utilizing EMR systems such as Lytec to maintain accurate patient records and ensure HIPAA compliance. Proven ability to deliver empathetic, bilingual (English/Spanish) patient communication, translating medical and insurance information to improve patient understanding and satisfaction. Strong collaborator with clinical and administrative teams, trained in coaching staff and streamlining workflows to enhance operational efficiency and patient experience. Dedicated to providing compassionate support through all stages of patient care, from pre-op preparation to post-procedure follow-up.
Overview
8
8
years of professional experience
1
1
Certification
Work History
Call Center Coordinator/Patient Relations Representative
New York Plastic Surgical Group
Garden City
07.2023 - Current
- Managed 50–100 inbound and outbound calls daily, addressing patient needs, appointment requests, and procedural questions with professionalism and empathy.
- Scheduled surgeries and consultations, coordinated physician calendars, and ensured timely communication between departments.
- Utilized Nextech EMR to update patient records, confirm insurance eligibility, and maintain compliance with HIPAA regulations.
- Resolved patient complaints and escalations tactfully, ensuring high levels of patient satisfaction and maintaining positive clinic reputation.
- Provided clear pre- and post-operative instructions, helping reduce patient confusion and improving surgical prep adherence.
- Decreased appointment no-show rates by 20% through consistent follow-up calls and effective reminder systems.
- Trained and supervised new staff on phone etiquette, EMR usage, and clinic protocols, ensuring a smooth onboarding process.
- Supported front desk operations when needed, contributing to a collaborative and efficient team environment.
- Communicated fluently in Spanish with patients and family members to explain procedures, answer questions, and ensure full understanding of medical and administrative information.
- Translated critical documents and appointment instructions for Spanish-speaking patients, improving access to care and reducing misunderstandings.
Call Center Supervisor
DR. SHYPULA'S FAMILY PRACTICE
Edison
05.2020 - 01.2023
- Led and managed a team of 10+ call center representatives in a specialized hematology and oncology clinic, overseeing daily operations to ensure seamless patient communication and scheduling.
- Developed and implemented training programs focused on the nuances of oncology patient care, medical terminology, and sensitivity when handling life-altering diagnoses.
- Monitored call metrics and performance KPIs such as call wait times, first-call resolution rates, and patient satisfaction scores, driving continuous improvement to exceed clinic standards.
- Collaborated with clinical staff, including hematologists, oncologists, and nurses, to ensure accurate dissemination of complex treatment schedules, lab results, and appointment logistics.
- Designed and enforced compliance protocols for HIPAA and oncology-specific privacy requirements, ensuring patient confidentiality in all communication channels.
- Spearheaded process improvements by integrating oncology-specific CRM software enhancements, improving documentation accuracy and follow-up scheduling efficiency.
- Conducted regular one-on-one coaching and performance reviews, motivating staff and identifying individual development plans to enhance team expertise in oncology patient relations.
- Served as the escalation point for complex patient issues, including treatment plan clarifications, insurance coverage concerns, and emotional support referrals, coordinating with social workers and patient advocates.
- Organized and led weekly interdisciplinary meetings with clinical and administrative teams to align patient communication strategies and resolve operational bottlenecks.
- Implemented a multilingual support program to better serve non-English-speaking oncology patients, collaborating with interpreters and translating materials to enhance patient experience.
- Managed call center staffing schedules and workload forecasting to optimize coverage during high-volume periods such as chemotherapy cycles and treatment plan changes.
- Championed patient education initiatives by coordinating the distribution of treatment brochures, financial aid resources, and community support group information via phone outreach.
Medical Assistant /Insurance Verification Representative
DILIGENT URGENT CARE
Union City
09.2017 - 04.2020
- Delivered comprehensive clinical and administrative support as a Medical Assistant, specializing in insurance verification and bilingual patient care in a high-volume surgical center.
- Verified patient insurance eligibility and benefits for surgeries, office visits, and diagnostic testing through payer portals and direct communication with insurance companies.
- Utilized Lytec EMR system to input and update accurate patient demographics, clinical notes, and insurance details while maintaining full HIPAA compliance.
- Secured prior authorizations and referrals for surgical procedures and imaging, proactively preventing billing delays and denials.
- Performed patient intake duties: recorded vital signs, updated medical histories, reconciled medications, and prepared exam rooms for consultations and procedures.
- Provided Spanish-speaking patients and families with clear explanations of medical procedures, financial responsibilities, and pre- and post-op instructions.
- Translated medical forms, instructions, and insurance documents in real time, ensuring clarity and full understanding for non-English speaking patients.
- Scheduled surgeries and follow-up appointments, coordinating closely with physicians, surgical staff, and insurance carriers to meet all pre-op requirements.
- Explained copays, deductibles, and out-of-pocket expenses to patients while offering assistance with payment plans and financial questions.
- Assisted in minor clinical procedures, maintained sterile environments, and ensured exam rooms were stocked and compliant with clinical protocols.
- Conducted follow-up calls post-procedure to assess recovery, answer questions, and provide continued support — both in English and Spanish.
- Trained new medical assistants on Lytec EMR, insurance workflows, clinical protocols, and best practices for bilingual patient interaction.
Education
Associate Degree - Criminal Justice
Hudson County Community College
Union City, NJDiploma - Medical Assisting
Lincoln Technical Institute
Edison, NJHigh School Diploma -
Carteret High School
Carteret, NJSkills
- Electronic Medical Records (EMR): Athena
- Electronic Medical Records (EMR): Epic
- Electronic Medical Records (EMR): Dentrix
- Electronic Medical Records (EMR): Modento
- Patient Scheduling & Check-In/Out
- Insurance Verification & Billing
- HIPAA & OSHA Compliance
- Injections
- Phlebotomy
- Diagnostic Testing
- Front Desk Management & Customer Service
- Bilingual Patient Communication (English/Spanish)
- Microsoft Office: Word
- Microsoft Office: Excel
- Microsoft Office: Outlook
- Call center management
Certification
- Certified Medical Assistant (CMA)
- CPR & First Aid Certified
- OSHA & HIPAA Compliant
Bilingual
- English
- Spanish
Highlights And Accomplishments
- Consistently recognized for professionalism, organization, and patient rapport.
- Achieved 95%+ satisfaction rating in patient feedback surveys.
- Trained new front desk staff and junior medical assistants.
- Recognized as bilingual asset for Spanish translation during complex medical explanations.
Timeline
Call Center Coordinator/Patient Relations Representative
New York Plastic Surgical Group
07.2023 - Current
Call Center Supervisor
DR. SHYPULA'S FAMILY PRACTICE
05.2020 - 01.2023
Medical Assistant /Insurance Verification Representative
DILIGENT URGENT CARE
09.2017 - 04.2020
Associate Degree - Criminal Justice
Hudson County Community College
Diploma - Medical Assisting
Lincoln Technical Institute
High School Diploma -
Carteret High School