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Claims Resolution Specialist

Claims Resolution Specialist

NaviRepublic Of India, IN
24 days ago
Job description

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

As an Executive – 2, Health Insurance Claims, you will play a critical role in ensuring

customers experience a smooth and transparent journey during their claims process.

You will be the voice of the customer within Navi, owning their end-to-end claim

journey—from admission intimation to final settlement—while collaborating with

multiple stakeholders such as doctors, hospitals, field investigators, and internal

business teams.

Your role requires empathy, high ownership, and problem-solving skills to balance

customer delight with process compliance.

What We Expect From You

  • Act as the primary point of contact for customers during their health insurance

claim journey.

  • Assist and guide customers through the cashless and reimbursement claim
  • process across multiple touchpoints (calls, chat, emails).

  • Coordinate with hospitals, doctors, field investigators, and internal teams to
  • resolve queries and ensure smooth claim approvals.

  • Track and monitor claim progress, keeping customers informed proactively until
  • settlement.

  • Identify and escalate fraud indicators or discrepancies in claims.
  • Meet defined SLAs for turnaround time, quality, and customer satisfaction.
  • Deliver a high CSAT experience by handling customer interactions
  • empathetically and professionally.

    Must Haves

  • Ability to take ownership, drive progress independently, and meet timelines.
  • Strong focus on solving customer pain points with empathy.
  • Clear and effective communicator in English, Hindi, and at least one regional
  • language.

  • Ability to validate documents, identify inconsistencies, and ensure compliance.
  • Willingness to work in rotational shifts (24 / 7 support) and rotational weekly
  • offs as per business requirements.

  • Team player with the ability to coordinate across multiple stakeholders.
  • Should have completed 2nd PUC (Pre-University Course) or higher.
  • 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 You'll 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.
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