Debra Bourque
Abbeville
Summary
Experienced customer service professional with over 40 years in client support, specializing in customer communications, needs assessment, and conflict resolution. Committed to delivering exceptional service and fostering positive relationships. Ready to leverage problem-solving skills and a customer-focused approach as a System Support Analyst I to enhance team success.
Overview
43
43
years of professional experience
Work History
System Support Analyst I
University of New Orleans
03.2025 - Current
- Detects and documents software failures, anomalies, and issues to identify and correct defects.
- Tracks identified system issues and verifies resolution.
- Works to resolve provider portal authorization tasks.
- Monitored and documented issues within the ticketing system to ensure timely resolutions.
- Documented JIRA items for further review and research to assist in issue resolution.
- Monitors for post-implementation issues.
- Ensures that service disruptions are reported immediately.
- Communicates relevant information to project team as needed.
- Participated in unit and project meetings to share updates and gather information.
- Completes project status reports as assigned.
- Attends unit and Project related meetings.
- Completed project status reports.
- Conducts research relating to the development of the modernization systems.
- Assists in preparing, interpreting and clarifying eligibility policies and procedures.
- Executed additional tasks to maintain seamless project operations.
PROCESSING SUPPORT – COORDINATOR I
University of New Orleans
Opelousas, LA
02.2024 - 03.2025
- Responded to phone inquiries from nursing facilities and external providers, documenting call reasons and directing callers to appropriate resources to ensure efficient resolution.
- Maintained accurate case notes in Electronic Document Management System (EDMS) to support effective tracking and management of documentation.
- Maintain accurate and detailed case notes in the Electronic Document Management System (EDMS) based on received documentation.
- Create tasks within the LaMEDS system to notify analysts of required actions related to incoming documents.
- Assisted applicants with application and renewal processes in Self-Service Portal, providing clear guidance to enhance user experience and streamline submissions.
- Communicate important issues and updates to supervisors through clear written and verbal communication.
- Performed additional administrative and support duties to ensure efficient daily operations.
Office Manager
ABBEVILLE ELECTRIC SUPPLY
Abbeville, LA
02.2022 - 02.2024
- Managed accounts payable and receivable with QuickBooks, ensuring accuracy and timeliness in financial processing.
- Prepared and processed customer invoices on a daily basis while maintaining accurate billing records.
- Assisted customers and vendors with billing inquiries, resolving issues promptly and providing excellent customer service.
- Resolved billing inquiries for customers and vendors promptly, enhancing customer satisfaction and service quality.
- Coordinated payroll processing and addressed employee benefits inquiries, supporting staff and ensuring compliance with medical insurance policies.
- Executed additional administrative and accounting duties to support daily business operations.
Medicaid Analyst 2 - WAE
LDH/BHSF/LTC
Lafayette, LA
02.2017 - 06.2022
- Determined financial and medical eligibility for Medicaid Long-Term Care and Waiver programs by reviewing applications, supporting documentation, and program requirements.
- Interpreted and applied complex federal, state, and agency policies to ensure accurate and compliant eligibility determinations.
- Evaluated financial records, medical documentation, provider forms, and medical certifications to assess eligibility and resolve discrepancies, ensuring compliance with Medicaid regulations.
- Analyzed financial resources, medical expenses, penalties, hardships, and recipient liabilities to determine eligibility and calculate financial responsibility.
- Prepared clear, accurate, and legally defensible eligibility determinations supported by thorough documentation and case analysis.
- Prepared clear, accurate, and legally defensible eligibility determinations, enhancing case integrity through thorough documentation and analysis.
- Managed caseloads of new applications, renewals, and case changes, ensuring timely compliance with federal and state processing timelines.
- Coordinated regularly with assigned providers, facilities, and program offices to ensure effective communication and timely resolution of case-related issues.
- Utilized the LaMEDS system to manage workflow, track tasks, and ensure all assignments were completed within established deadlines.
- Participated in ongoing Medicaid policy, procedural, and systems training at the unit, regional, and statewide levels to maintain current knowledge and support continuous improvement.
- Executed supplementary responsibilities to support the Eligibility Field Operations mission.
Project Manager
DHH/BHSF
Baton Rouge, LA
03.2016 - 08.2016
- Collaborated with program developers to design and implement new Medicaid Eligibility System, leveraging subject matter expertise on eligibility policies and business processes to enhance system accuracy.
- Provided guidance on Medicaid program types, eligibility requirements, and business rules to support system development and testing.
- Interpreted and explained complex Medicaid policies and procedures to ensure accurate system functionality for initial applications, renewals, and ongoing eligibility determinations.
- Defined notice requirements with development teams, ensuring recipient, applicant, and provider communications were accurate, complete, and compliant with policy standards.
- Translated policy requirements into functional system specifications, contributing to streamlined system processes and improved user experience.
Medicaid Analyst 2
DHH/BHSF
Lafayette, LA
09.2015 - 03.2016
- Interpreted and applied complex federal, state, and agency policies to ensure accurate and compliant eligibility determinations.
- Determined financial and medical eligibility for Medicaid Long-Term Care and Waiver programs by reviewing applications, financial records, medical documentation, and supporting evidence.
- Evaluated case documentation, resolved discrepancies, and obtained additional information from applicants, providers, and other agencies to support timely and accurate case processing.
- Verified provider forms and medical certifications for compliance with program requirements and eligibility criteria, resolving inconsistencies to ensure accurate determinations.
- Collaborated with diverse stakeholders, including applicants, providers, service coordinators, and advocacy groups, to gather information and expedite case resolutions.
- Analyzed financial resources, medical expenses, penalty periods, hardships, and recipient liabilities to determine eligibility and calculate financial responsibility.
- Prepared thorough, well-documented, and legally defensible eligibility determinations in accordance with Medicaid policies and regulations.
- Managed assigned caseloads, including new applications, renewals, and case changes, while ensuring compliance with federal and state processing deadlines.
- Managed workflow and monitored tasks in MEDS system to ensure accurate case processing and timely completion of assignments.
- Maintained regular communication with providers, long-term care facilities, and program offices to ensure efficient case coordination and exceptional customer service.
- Participated in ongoing Medicaid policy, procedures, systems, and professional development training at the unit, regional, and statewide levels to stay current with program changes.
- Executed various tasks to support the Eligibility Field Operations mission and organizational goals.
Program Monitor
DHH/BHSF/SUPPORTS SECTION
Baton Rouge, LA
11.2013 - 09.2015
- Managed all functions of the Medicaid toll-free hotline, providing courteous, accurate, and timely assistance to callers.
- Addressed inquiries about Medicaid programs, eligibility, and services, providing clear and helpful guidance to callers.
- Researched and resolved Medicaid inquiries from the public, providers, and other organizations in a prompt and professional manner.
- Acted as a liaison between the department and the public, fostering positive relationships and delivering exceptional customer service.
- Documented inquiries accurately and facilitated consistent communication, aligning with department's commitment to quality service.
Medicaid Analyst 2
DHH/BHSF
Lafayette, LA
06.2013 - 11.2013
- Interpreted and applied complex federal, state, and agency policies to ensure accurate, consistent, and compliant eligibility determinations.
- Analyzed financial resources, medical expenses, hardships, penalty periods, and recipient liabilities to determine eligibility and calculate financial responsibility.
- Determined financial and medical eligibility for a variety of Medicaid programs by reviewing applications, financial records, medical documentation, and supporting evidence.
- Evaluated provider forms and medical certifications to verify consistency with eligibility requirements, resolving inconsistencies.
- Collaborated with applicants, providers, service coordinators, advocacy groups, attorneys, financial institutions, and other stakeholders to gather information, ensuring comprehensive case resolution.
- Prepared detailed, accurate, and legally defensible eligibility determinations supported by thorough documentation and policy analysis.
- Prepared accurate, legally defensible eligibility determinations, ensuring thorough documentation and policy analysis supported timely case processing.
- Collaborated with applicants, providers, service coordinators, advocacy groups, attorneys, financial institutions, and other stakeholders to gather information and facilitate case resolution.
- Managed workflow and task assignments within the MEDS system, ensuring applications, renewals, and case actions were completed within established federal and state timeframes.
- Participated in ongoing training on Medicaid policies, procedures, and system enhancements to maintain current knowledge and support continuous improvement.
- Performed additional duties as assigned in support of Eligibility Field Operations and the delivery of high-quality public service.
Medicaid Analyst 2
DHH/BHSF
Lafayette, LA
01.2006 - 06.2013
- Interpreted and applied complex federal, state, and agency policies to ensure accurate, consistent, and compliant eligibility determinations.
- Determined financial and medical eligibility for a variety of Medicaid programs by reviewing applications, financial records, medical documentation, and supporting evidence.
- Evaluated case documentation, resolved discrepancies, and obtained additional information from applicants, providers, and other agencies to support timely and accurate case processing.
- Reviewed provider forms and medical certifications for compliance with eligibility requirements, resolving inconsistencies to ensure accurate determinations.
- Collaborated with applicants, providers, service coordinators, advocacy groups, attorneys, and financial institutions to gather information and expedite case resolution.
- Analyzed financial resources, medical expenses, and hardship factors to determine eligibility and calculate financial responsibility accurately.
- Prepared clear, detailed, and legally defensible eligibility determinations supported by thorough documentation and policy analysis.
- Coordinated with providers, healthcare facilities, and program offices to ensure effective communication and timely resolution of eligibility issues.
- Managed workflow and task assignments within the MEDS system, ensuring applications, renewals, and case actions were completed accurately and within federal and state processing timeframes.
- Participated in ongoing training on Medicaid policies, procedures, and system enhancements to maintain current knowledge and support continuous process improvement.
- Executed additional duties to support eligibility field operations and enhance public service delivery.
Patient Access Representative
Parallon Business Solutions/Women & Children Hospital
12.2008 - 05.2013
- Deliver exceptional customer service by building positive patient relationships, ensuring patient satisfaction, and representing the Patient Access department with professionalism, courtesy, and compassion at all times.
- Provide a personalized registration experience by greeting patients warmly, addressing them by name, assessing individual needs, and completing registrations accurately, efficiently, and in a timely manner.
- Collect, verify, and accurately enter patient demographic, insurance, guarantor, and registration information while maintaining the integrity of patient records and ensuring a single medical record number is assigned.
- Apply critical thinking and sound judgment to evaluate each registration scenario and tailor the registration process to meet individual patient circumstances.
- Maintain compliance with federal and state regulations, including EMTALA, HIPAA, HITECH, the No Surprises/Balanced Billing Act, Medicare Secondary Payer guidelines, workers' compensation regulations, patient status requirements, Advance Beneficiary Notices (ABNs), and other applicable healthcare laws and organizational policies.
- Explained hospital consent forms, patient rights, assignment of benefits, and other required documentation, securing necessary patient or legal guardian signatures for compliance.
- Document patient interactions thoroughly and accurately to support effective communication across clinical and administrative teams.
- Review physician orders for accuracy and completeness, resolving discrepancies or missing information to ensure timely patient care and registration.
- Monitored patient flow and waiting areas, proactively addressing issues to enhance registration efficiency and improve patient experience.
- Demonstrate comprehensive knowledge of insurance plans, payer requirements, prior authorization processes, and coverage guidelines to facilitate accurate registration and billing.
- Verify insurance eligibility using electronic verification tools whenever available and secure required authorizations prior to services being rendered.
- Accurately identify and assign primary and secondary insurance coverage within the registration system.
- Educated patients on necessary forms and documentation requirements for compliance. on required forms, including the Medicare Secondary Payer Questionnaire, ensuring understanding and compliance.
- Utilize payment estimation tools to calculate patient financial responsibility, verify estimate accuracy, and clearly explain out-of-pocket costs to patients.
- Identify patients who may qualify for financial assistance and connect them with appropriate financial counseling and available resources.
- Collect patient financial responsibility at or before the time of service using established customer service techniques, payment collection best practices, and organizational policies.
- Explain account balances, payment obligations, and insurance-related charges by reviewing current and historical account documentation.
- Complete account acknowledgment forms and other financial documentation accurately and in accordance with organizational requirements.
- Process payments, issue receipts, reconcile cash drawers, and maintain accountability for daily cash handling procedures.
Medicaid Area Manager
DHH/BHSF
Abbeville, LA
05.1996 - 01.2006
- Supervised a team of six Medicaid Analysts and two Office Coordinators, providing leadership, guidance, and support to promote a productive and collaborative work environment.
- Established performance standards and developed procedures to enhance service delivery in parish office operations.
- Established performance standards for parish office operations and developed procedures to improve efficiency and ensure high-quality service delivery.
- Scheduled work assignments, set team priorities, and adjusted staffing and workloads to meet operational goals and changing business needs.
- Coached and mentored staff to promote professional development and ensure compliance with Medicaid policies and performance expectations.
Eligibility Determination Examiner II
DHH/BHSF
New Iberia, LA
03.1993 - 05.1996
- Determined financial and medical eligibility for a variety of Medicaid programs, including Long-Term Care programs, by reviewing applications, financial records, medical documentation, and supporting evidence.
- Interpreted and applied complex federal, state, and agency policies to ensure accurate, consistent, and compliant eligibility determinations.
- Analyzed financial resources, medical expenses, hardship requests, penalty periods, and recipient liabilities to determine eligibility and calculate financial responsibility.
- Reviewed provider forms and medical certifications to verify compliance with eligibility requirements, resolving inconsistencies to uphold program integrity.
- Evaluated case documentation, resolved discrepancies, and obtained additional information from applicants, providers, and other agencies to support timely and accurate case processing.
- Reviewed provider forms and medical certifications to verify compliance with eligibility requirements and resolved inconsistencies when necessary.
- Collaborated with applicants, providers, service coordinators, advocacy groups, attorneys, financial institutions, and other stakeholders to gather information and facilitate case resolution.
- Coordinated with providers, healthcare facilities, and program offices to facilitate effective communication and ensure timely resolution of eligibility issues.
- Managed workflow and task assignments within the MEDS system, ensuring applications, renewals, and case actions were completed accurately and within established federal and state timeframes.
- Participated in ongoing training on Medicaid policies, procedures, and system enhancements to maintain current knowledge and enhance service delivery.
- Executed various tasks to support Eligibility Field Operations and enhance public service delivery.
Caseworker Assistant
STATE OF LOUISIANA/OFFICE OF COMMUNITY SERVICES
Abbeville, LA
05.1988 - 03.1993
- Processed payments for foster care parents, ensuring accurate and timely reimbursement of expenses to support the welfare of foster children.
- Prepared and typed correspondence, court orders, and legal documents for Child Protection cases while maintaining a high level of accuracy and confidentiality to uphold legal standards.
- Maintained organized records and ensured documentation compliance to support the Child Protection team in meeting agency requirements.
Information Systems Data Entry Operator 2
STATE OF LOUISIANA/OFFICE OF FAMILY SUPPORT
Abbeville, LA
08.1983 - 05.1988
- Entered and updated data related to applications and certifications in computerized systems, facilitating timely case changes and decision-making.
- Maintained accurate records by entering data promptly while adhering to established policies and procedures.
- Ensured meticulous case processing by applying strong attention to detail and upholding data accuracy.
Education
High School Diploma -
ABBEVILLE HIGH SCHOOL
Abbeville, LA06-1982
Skills
- Medicaid policy knowledge
- LaMEDS system knowledge
- Long-term care programs
- C and D programs knowledge
- LMMIS and MMIS knowledge
- Help desk support
- Microsoft windows and office
- Technical support
- Attention to detail
- Organizational skills
- Time management
- Analytical skills
- Reliability
- Excellent communication
- Customer service
- Problem-solving abilities
Timeline
System Support Analyst I
University of New Orleans
03.2025 - Current
PROCESSING SUPPORT – COORDINATOR I
University of New Orleans
02.2024 - 03.2025
Office Manager
ABBEVILLE ELECTRIC SUPPLY
02.2022 - 02.2024
Medicaid Analyst 2 - WAE
LDH/BHSF/LTC
02.2017 - 06.2022
Project Manager
DHH/BHSF
03.2016 - 08.2016
Medicaid Analyst 2
DHH/BHSF
09.2015 - 03.2016
Program Monitor
DHH/BHSF/SUPPORTS SECTION
11.2013 - 09.2015
Medicaid Analyst 2
DHH/BHSF
06.2013 - 11.2013
Patient Access Representative
Parallon Business Solutions/Women & Children Hospital
12.2008 - 05.2013
Medicaid Analyst 2
DHH/BHSF
01.2006 - 06.2013
Medicaid Area Manager
DHH/BHSF
05.1996 - 01.2006
Eligibility Determination Examiner II
DHH/BHSF
03.1993 - 05.1996
Caseworker Assistant
STATE OF LOUISIANA/OFFICE OF COMMUNITY SERVICES
05.1988 - 03.1993
Information Systems Data Entry Operator 2
STATE OF LOUISIANA/OFFICE OF FAMILY SUPPORT
08.1983 - 05.1988
High School Diploma -
ABBEVILLE HIGH SCHOOL