Field Investigation Officer

1 month ago

Bangalore Urban, India Navi Full time

About Navi

Navi is one of the fastest-growing financial services companies in India providing Personal & Home Loans, UPI, Insurance, Mutual Funds, and Gold. Navi's mission is to deliver digital-first financial products that are simple, accessible, and affordable. Drawing on our in-house AI/ML capabilities, technology, and product expertise, Navi is dedicated to building delightful customer experiences.


Founders: Sachin Bansal & Ankit Agarwal


Know what makes you a “Navi_ite” :

1.Perseverance, Passion and Commitment

• Passionate about Navi’s mission and vision

• Demonstrates dedication, perseverance and high ownership

• Goes above and beyond by taking on additional responsibilities


2.Obsession with high quality results

• Consistently creates value for the customers and stakeholders through high quality outcomes

• Ensuring excellence in all aspects of work

• Efficiently manages time, prioritizes tasks, and achieves higher standards


3.Resilience and Adaptability

• Adapts quickly to new roles, responsibilities, and changing circumstances, showing resilience and agility


What would your role at Navi Look Like?


  • Conduct on-ground field investigations across Hospitals, policyholders' locations and related places to gather information and evidence related to health insurance claims. This may include reviewing medical records, interviewing claimants, hospital/ Laboratory/ Pharmacy staff, and inspecting the circumstances surrounding the claim.
  • Assess the validity of claims by verifying the accuracy of medical documentation, treatment plans, and billing information.
  • Investigate claims suspected of fraudulent activity or misrepresentation. Identify red flags, inconsistencies, or patterns that warrant further scrutiny.
  • Maintain detailed records of field investigations, including observations and collected evidence. Prepare a comprehensive report of every case by summarizing findings, analysis, and recommendations for claims adjudication.
  • Submit the investigation findings through reporting, within the allotted time period.
  • Coordinate with the internal team to share insights and findings that contribute to informed claims decisions.

What are some good to have skills for this role?


  • On-field Execution Experience - Field/On ground experience in insurance or medical or related fields
  • Analytical thinking - ability to critically assess information, recognize patterns and draw a logical conclusion
  • Attention to details - thoroughness in reviewing the documents, identifying the discrepancies and ensuring the accuracy of the process
  • Good understanding of insurance claim processing and Health Claim Investigation process
  • Good understanding of the hospitalization process, different departments of hospital and basic knowledge of medical ailments would be preferred
  • Excellent communication skills, including writing emails and good command on MS Excel
  • Ability to work collaboratively with internal teams

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