Lana Moore
New York
Summary
Experienced professional in Leave of Absence and ADA program management with over 7 years in the field and 1 year in healthcare claims auditing. Expertise in regulatory compliance, plan document interpretation, and claims review processes. Capable of managing high-volume workloads with precision and efficiency while ensuring confidentiality and fostering cross-functional collaboration.
Overview
13
13
years of professional experience
Work History
Healthcare Support Specialist
Nuvance Health
Stamford
09.2025 - Current
- Facilitated eligibility verification and benefits interpretation for members and providers, enhancing understanding of coverage options.
- Reviewed healthcare documentation to ensure compliance with policy guidelines, supporting regulatory adherence and risk management.
- Maintained accurate records and supported quality assurance initiatives.
- Managed multiple administrative tasks while meeting departmental productivity goals.
- Provided courteous and professional communication to internal and external stakeholders
HR Recruitment Representative
American Red Cross
Washington
09.2021 - 06.2025
- Managed and maintained accurate employee status data within HRIS to ensure reliable reporting and compliance
- Processed and audited employee transactions including hires, terminations, promotions, transfers, and compensation changes to uphold data integrity
- Supported payroll processing and ensured time and attendance data integrity
- Reconciled and validated HR and payroll data to maintain compliance and reporting accuracy
- Collaborated with HR, payroll, and management teams to resolve data discrepancies, enhancing overall data accuracy
- Maintained confidentiality and complied with labor regulations and company policies
Credentialing Coordinator
Genre
Stamford
01.2016 - 09.2019
- Interpreted and applied plan documents to determine claim eligibility and payment accuracy.
- Audited pre- and post-payment claims to ensure accuracy, eligibility, and compliance with plan documents.
- Identified processing errors and recommended corrective actions to reduce future discrepancies.
- Partnered with claims examiners and account representatives to effectively resolve discrepancies and enhance accuracy.
- Managed production queue, ensuring timely completion of multiple reviews daily while upholding quality standards.
- Utilized DG system (or comparable claims processing software) to document and finalize claim reviews.
- Maintained high productivity and accuracy in a fast-paced, metrics-driven environment.
- Contributed to special audit assignments and internal meetings aimed at streamlining operational processes.
HR Leave of Absence Specialist
Charter Spectrum
Stamford
08.2013 - 05.2015
- Administered FMLA, ADA, and Paid Family Leave programs for a multi-state employee population.
- Ensured compliance with federal, state, and local leave laws, minimizing risk of legal issues.
- Facilitated communication between third-party leave vendor, HR leadership, and legal counsel to resolve complex leave cases.
- Developed and delivered training and guidance to managers and supervisors on leave processes and return-to-work accommodations.
- Provided expertise on leave, accommodations, and compliance to support HR and enterprise initiatives.
- Responded to employee and manager inquiries related to leave eligibility, documentation, and accommodations.
Education
Bachelor of Science - Legal Studies
Kaplan University
Chicago, IL01.2014
Skills
- Patient Records Management
- PeopleSoft
- Workday
- SAP
- Paychex
- Service Now
- MS Office Suite
- Outlook
- HTML
- Advanced Internet Research
- Red Carpet
Affiliations
Society for Human Resource Management (SHRM), 2015
Professional Development
- Wage and Hour Law Update
- Advanced Microsoft Office (2020)
- SHRM Seminars: Workplace Violence, Employment Law, Recruitment & Selection, Compensation
Timeline
Healthcare Support Specialist
Nuvance Health
09.2025 - Current
HR Recruitment Representative
American Red Cross
09.2021 - 06.2025
Credentialing Coordinator
Genre
01.2016 - 09.2019
HR Leave of Absence Specialist
Charter Spectrum
08.2013 - 05.2015
Bachelor of Science - Legal Studies
Kaplan University