Associate Manager II

3 months ago

bangalore, 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
Key responsibilities:
1. Review and evaluate the medical claim process by analyzing a sample of claims on a day-to-day basis.
The aim would be to improve accuracy of insurance claim decisions, reduce processing time and costs, explore unused data points for better decision-making, and identify potential fraud patterns.
The expected output of the reviews would be a report, summarizing the key observations and highlighting clear action items
3. Discussion with the Medical Staff: Engage in discussions with treating physicians and relevant medical personnel to gain insights and clarification on medical aspects of claims.
4.Data Analysis: Analyze the data and make informed decisions regarding further actions or identifying potential problem areas for reviews
5.Collaborate with several stakeholder functions, such as medical officers, external agency, analytics and product teams
6.Own the recommendations made from this process, & action to take them to appropriate conclusions
What we are looking for:
Medical Graduate in any stream (MBBS/BHMS/BAMS/BUMS/BDS)
Critical Thinking: Capacity to assess the appropriateness and necessity of medical treatments and procedures
Excellent analytical skills and eye to detail, to be able to look at problems using first principles
Experience or exposure to medical claims process with some medical insurance company
Excellent communication skills, including writing reports and summaries
Collaborative as well as assertive in interactions with stakeholders
Understanding of insurance industry, in a digital ecosystem, preferably
Ability to work independently and drive projects

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