About the Team
The Process Excellence team at Navi is focused on maintaining and elevating the quality of customer interactions. As the quality audit function, the team conducts regular audits of agent communications across calls, chats, and other channels to ensure accuracy, consistency, and compliance. The team also ensures compliance across different verticals and runs multiple initiatives in coordination with business team stakeholders to drive key business metrics. Insights from these audits are used to drive continuous improvement through targeted training, helping agents close knowledge or process gaps and deliver a consistently excellent customer experience.
About the Role
We are seeking an experienced Doctor with medical knowledge for the Process Excellence vertical to join our dynamic team. As a vital member of our Process Excellence team, a quality auditor dedicated exclusively to auditing claims processed by medical officers to ensure accuracy, compliance, and continual improvement. A quality auditor conducts detailed reviews of claims, identifying areas for improvement..
What We Expect From You
Review submitted health claims for accuracy, completeness, and compliance with insurance policies and applicable regulations. Reviewing and evaluating medical claims to determine their eligibility for payment, and investigating medical claims to identify fraud. Making decisions about medical claims, such as whether to approve or deny a claim Liaison with internal stakeholders to ensure the deadlines of TAT s and SLA s Work towards designated tasks. Claim Analytics- Periodical claim analysis to identify frauds, monitor claim performance metrics. Informing the customer about the rejection of their claim through a call. Must Haves
The role involves identifying discrepancies, fraud, or errors in claims to ensure compliance with health insurance policies and regulatory requirements. Ability to handle independent assignments having the acumen to draw logical conclusions. He/she should have a broad understanding of Claims Practice. Sharp business acumen to understand health insurance claim servicing needs.. Excellent communication skills, including writing reports and presentations. Ability to anticipate potential problems and take appropriate corrective action. Knowledge of health regulations, IRDA circulars is a must. Knowledge of different languages would be an added advantage. Proficiency in Hindi and English is mandatory. Medical Graduate in any stream (MBBS/BHMS/BAMS/BUMS/BDS) Experience in handling an audit. Background in claims processing with clinical experience in a hospital setting. Candidates having data analytics experience would be an added advantage.
Inside Navi
We are shaping the future of financial services for a billion Indians through products that are simple, accessible, and affordable. From Personal Home Loans to UPI, Insurance, Mutual Funds, and Gold we re building tech-first solutions that work at scale, with a strong customer-first approach. Founded by Sachin Bansal Ankit Agarwal in 2018, we are one of India s fastest-growing financial services organisations. But we re just getting started! Our Culture
The Navi DNA
Ambition. Perseverance. Self-awareness. Ownership. Integrity. We re looking for people who dream big when it comes to innovation. At Navi, you ll be empowered with the right mechanisms to work in a dynamic team that builds and improves innovative solutions. If you re driven to deliver real value to customers, no matter the challenge, this is the place for you. We chase excellence by uplifting each other and that starts with every one of us. Why Youll Thrive at Navi
At Navi, it s about how you think, build, and grow. You ll thrive here if You re impact-driven You take ownership, build boldly, and care about making a real difference. You strive for excellence Good isn t good enough. You bring focus, precision, and a passion for quality. You embrace change You adapt quickly, move fast, and always put the customer first. 
