Entela Alimema
@entelaalimema
Detail-oriented provider enrollment and customer service professional with strong administrative skills.
What I'm looking for
I am a detail-oriented provider enrollment representative with extensive customer service and administrative experience across healthcare and retail environments. I specialize in ensuring providers are accurately enrolled with payers and maintaining compliance in internal systems.
I have a track record of managing documentation, verifying credentials, submitting applications to insurers, and tracking enrollment progress to resolution. My work emphasizes accuracy, timely follow-up, and maintaining up-to-date provider information.
Prior roles in retail management and customer-facing positions honed my leadership, inventory control, and problem-resolution abilities. I bring advanced Microsoft Office skills, strong bilingual communication (English and Albanian), and working proficiency in Italian.
I am committed to contributing reliable administrative support, efficient process management, and excellent stakeholder communication to a team focused on healthcare operations or administrative services.
Experience
Work history, roles, and key accomplishments
Provider Enrollment Representative
Wellsense
Jan 2020 - Jun 2025 (5 years 5 months)
Managed provider registrations with insurers and government programs, collecting and verifying credentials and submitting applications to ensure timely payments and compliance. Tracked application status and maintained accurate provider records, improving enrollment accuracy and renewal readiness.
Jewelry and Accessories Manager
Walmart
Oct 2019 - Jan 2020 (3 months)
Led merchandising and inventory for jewelry and accessories, built displays per corporate plan, managed stock replenishment and pricing, and supervised floor associates to maintain sales and presentation standards.
Claims Associate
Walmart
May 2019 - Oct 2019 (5 months)
Processed returned, defective, and hazardous items and managed clearance areas to maintain safety and inventory accuracy. Executed markdowns and organized merchandise for efficient floor operations.
Personal Shopper
Walmart
Jul 2017 - May 2019 (1 year 10 months)
Managed online order fulfillment by receiving shipments, staging packages, picking customer orders, and coordinating customer pickups while resolving order issues to ensure timely delivery.
Cashier
Walmart
Oct 2016 - Jul 2017 (9 months)
Processed transactions, resolved customer inquiries, maintained sales floor presentation, and balanced cash drawer while multitasking in a fast-paced retail environment.
Delivered high-level customer service, processed cash and card transactions with accuracy, trained new employees, and maintained orderly sales spaces and floor displays.
Customer Care Agent
Albacall
Feb 2015 - Jun 2016 (1 year 4 months)
Answered client inquiries, determined requirements, researched solutions, and resolved issues through escalation when needed, maintaining service quality and customer satisfaction.
Archive Protocol Specialist
National Commercial Bank - BKT
May 2012 - Feb 2013 (9 months)
Performed quality control of documentation, updated client records and protocol amendments, and followed departmental processes to meet production and accuracy standards.
Education
Degrees, certifications, and relevant coursework
Bunker Hill Community College
Health Information Networking
2019 -
Enrolled in Health Information Networking program beginning in January 2019.
ISSAT
Human Resources Management
2010 - 2010
Completed an intensive specialization course in Management of Human Resources in October–November 2010.
University of Tirana
University degree, Italian Language and Literature
2001 - 2005
Earned a university degree in Italian Language and Literature from 2001 to 2005.
Tech stack
Software and tools used professionally
Availability
Location
Authorized to work in
Job categories
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