Tianna Jones
Summary
Professional with years of experience in crisis escalation, accurate documentation, and high-pressure decision-making. Skilled in verifying critical information, resolving issues quickly, and maintaining confidentiality in regulated environments.
Overview
1
1
Certification
2
2
years of professional experience
Work History
Inbound Customer Service Representative
Humana
Palmetto
07.2025 - 03.2026
- Resolved complex Medicare member inquiries regarding benefits, claims, and pharmacy coverage with high accuracy.
- Ensured HIPAA and CMS compliance during identity verification and PHI protection.
- Coordinated with providers and pharmacies to confirm authorizations, medication coverage, and appointment details.
- Achieved call performance metrics consistently, including quality assurance scores and first-call resolution.
Crisis Response Support Representative
Magellan Health
Palmetto
05.2025 - 07.2025
- Identified crisis language, including suicidal ideation and self-harm indicators, to effectively assess and respond to mental health emergencies.
- Provided calm, empathetic de-escalation for distressed members, fostering safety and building rapport.
- Educated members on mental health benefits and crisis resources to enhance understanding and access to support.
Alarm Monitor
Becklar
Sarasota
01.2024 - 07.2025
- Executed multi-step verification protocols, ensuring proper escalation to appropriate personnel for timely response.
- Dispatched police, fire, or EMS for high-risk or unverified alarms, delivering precise incident details to facilitate rapid emergency response.
- Conducted structured intake for burglar, fire, panic, and medical alarms using secure monitoring systems.
- Documented alarm activity with chain-of-custody accuracy, maintaining comprehensive records of time stamps, call attempts, and dispatch actions.
Licensed Insurance Representative
Gallagher Bassett
Bradenton
07.2024 - 02.2025
- Oversaw renewals, cancellations, reinstatements, and mid-term adjustments for professional liability policies, ensuring compliance and accuracy.
- Completed updates to coverages, limits, named insureds, and professional classifications with accuracy.
- Supported licensed agents in addressing policy questions and clarifying coverage details, enhancing agent-client relationships.
- Collaborated with carriers and underwriters to streamline policy processing and improve communication.
Education
High School Diploma -
Richard Milburn Academy
DeLand, FL05-2013
Skills
- Crisis intervention
- Incident reporting
- Verification processes
- Medicare coordination
- Conflict resolution
- Compliance & Confidentiality
- HIPAA compliance
- Claims resolution
Certification
- 4-40 Insurance Customer Service
Timeline
Inbound Customer Service Representative
Humana
07.2025 - 03.2026
Crisis Response Support Representative
Magellan Health
05.2025 - 07.2025
Licensed Insurance Representative
Gallagher Bassett
07.2024 - 02.2025
Alarm Monitor
Becklar
01.2024 - 07.2025
High School Diploma -
Richard Milburn Academy