2 Navi Technologies Medical Officer Jobs

What Were Looking For:

Were seeking a motivated Medical Officer with expertise in medical claim adjudication to join our dynamic team. If you have a medical background, a keen understanding of claims processes, and a passion for delivering high-quality results, we want to hear from you!

Responsibilities:

• Review and evaluate medical claims to determine payment eligibility.
• Investigate claims for potential fraud and ensure compliance with IRDA regulations and guidelines.
• Communicate effectively with claimants, providers, and other stakeholders regarding claims decisions.
• Negotiate with treating doctors/hospitals to reduce unjustified hospitalization costs.
• Drive improvements and automation in claims processes.
• Monitor systems and processes to maintain high performance standards.
• Ensure adherence to TATs (Turnaround Times) and SLAs (Service Level Agreements) in collaboration with internal teams.
• Resolve customer grievances efficiently within stipulated timelines.
• Analyze claims data to identify trends, fraud patterns, and optimize performance metrics.
• Inform customers about claim rejections via direct communication.
• Build and manage a team of processing doctors to support claims operations.

Qualifications:

• Medical Graduate (MBBS/BHMS/BAMS/BUMS/BDS).
• Proficiency in English and Hindi; additional languages are an advantage.
• Strong understanding of claims processes, health regulations, and IRDA guidelines.
• Excellent communication, analytical, and problem-solving skills.
• Experience in data analytics is a plus.
• Ability to manage independent assignments and deliver results under tight deadlines.

Why Join Us?

At Navi, youll become a Navi_ite if you exhibit:

• Perseverance, Passion, and Commitment
• Dedication to our mission and high ownership of responsibilities.
• Obsession with Quality
• Delivering value through consistent, high-quality outcomes.
• Resilience and Adaptability
• Thriving in dynamic environments and embracing challenges with agility.

What We Offer:

• An opportunity to work with one of Indias leading financial services companies.
• A chance to make a meaningful impact on the health insurance sector.
• A collaborative and growth-oriented work environment.