Shanira Dirton

UnitedHealthcare (Remote) — Health Advisor | May 2022 – Present

• Handle complex, high-priority cases requiring coordination across multiple stakeholders, ensuring timely resolution and consistent service delivery

• Streamline care coordination and claims workflows, reducing delays and ensuring timely access to care for 200+ members weekly

• Manage insurance verification, claims processing, and case reviews for 200+ members weekly, improving turnaround time and reducing delays

• Serve as primary point of contact for 80+ daily member and provider interactions**, resolving issues and improving access to care

• Maintain accurate, high-volume EHR documentation ensuring compliance and continuity of care

• Audited patient records, coding, and claims to improve accuracy and compliance

• Maintained EPIC medical records and ensured data integrity

• Supported patient intake, scheduling, and system updates

• Assisted with billing review and claims validation

. Supervised a team of 8 employees, driving performance, productivity, and service quality in a fast-paced environment

. Improved operational efficiency by 15–20% through workflow optimization and performance monitoring

. Managed scheduling, reporting, and workload distribution to meet business targets and service levels

. Coached and developed team members, contributing to performance improvements and stronger team outcomes

• Supported individuals with behavioral needs through structured care

• Collaborated with staff and families on individualized plans