Senior Executive - Field Investigator

About the Team

The Claims team at Navi is responsible for delivering a fast, transparent, and customer-first claims experience. From initial intimation to final settlement, whether cashless or reimbursement they manage the end-to-end process with a strong focus on accuracy and turnaround time. The team works closely with the Hospital Partnerships team to streamline coordination and uses data-driven insights and process automation to improve claim resolution speed and customer satisfaction.

About the Role

This role involves end-to-end responsibility for identifying and addressing potential fraud in medical claims. Key activities include reviewing claims for triggers, planning and overseeing field investigations, engaging with treating medical staff, guiding and

training investigation teams, analyzing data for informed decision-making, and collaborating with internal and external stakeholders to ensure effective fraud management.

What We Expect From You

• Review and Evaluate Medical Claims: Thoroughly examine medical claims to identify potential trigger points indicative of fraudulent activity.
• Plan the field investigation: Develop comprehensive strategies and plans for conducting field Investigations and share them with field investigators
• Discussion with the Medical Staff: Engage in discussions with treating physicians and relevant medical staff personnel to gain insights and clarification on the medical aspects of claims
• Conduct Field Investigation: Execute field investigations as necessary, working alongside the field Investigators are to gather evidence and information
• Stakeholder Management: Collaborate with different stakeholders

Must Haves

• People Management: Able to collaborate and communicate effectively with different teams
• Process Acumen: Ability to handle independent assignments & have the acumen to draw logical conclusions
• Attention to Details: Thoroughness in reviewing the claim documents, insurance policies, and the Investigation process to ensure accuracy
• Critical Thinking: The Capacity to assess the appropriateness and necessity of medical treatments and procedures based on established guidelines
• Problem-Solving: Aptitude for identifying challenges, developing innovative solutions, and implementing strategies to mitigate risks and prevent fraudulent activities
• Communication: Excellent communication skills, including writing reports and presentations

About Navi

We are on a mission to make finance simple, accessible and affordable for a billion Indians. Guided by a strong customer-first approach, we are building tech-first solutions that work at scale. Our offerings include a range of financial products and services across Loans, Insurance, Mutual Funds, Digital Gold and UPI.

Founded by Sachin Bansal & Ankit Agarwal in 2018, we are one of Indias fastest-growing financial services organisations. But were just getting started!

Our Culture

At Navi, were a place where ambition meets opportunity and ideas turn into impact quickly. We empower people with high ownership from the start, encouraging them to solve meaningful problems and build with excellence. Teams here work in an environment that values speed, collaboration and craftsmanship, while celebrating learning, growth and shared wins along the way. Whether youre shaping the future of fintech products or driving innovation behind the scenes, life at Navi means being part of a high-energy, talent-driven workplace where your contributions truly make a difference.

Were guided by our own operating system - The Navi OS - a set of principles that shape how we work and win together. You can explore them at navi.com/our-values to see what drives us every day.

If this feels like you, Navi is the place to grow, thrive and make a real impact.