SBO

Medical Officer - Claim Escalation (S4)

Bengaluru, Karnataka
Work Type: Full Time

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 

We are seeking a dedicated and compassionate Medical Officer to join our De-Escalation Team. This role will involve managing & mitigating escalated claim-related issues, with a focus on handling sensitive customer interactions in a calm and empathetic manner. The Medical Officer will work closely with customer service, claims teams, and healthcare professionals to provide expert medical advice and support in resolving claims disputes. The ideal candidate will have strong communication skills, a deep understanding of medical protocols and insurance claims, and the ability to help diffuse complex situations 

What We Expect From You 

● Medical Expertise in Claims Escalation 

Provide clinical expertise and insight into escalated claims, particularly where medical treatment, procedures, or diagnoses are involved. Review and assess the medical aspects of claims to ensure they align with policy coverage.

● De-escalation of customer issues 

Serve as the primary contact for escalated customer claims and concerns, responding with calm empathy, addressing issues diplomatically, and ensuring satisfaction while adhering to company policies 

● De-escalation of customer issues Conflict Resolution through internal collaboration Be the voice of the customer in Navi and work closely with the claims processing and other related teams to ensure smooth resolution of escalated cases. 

● Rejection Call Handling 

Manage rejection calls with empathy, clearly explaining the reasons behind claim rejections and offering guidance on next steps 

● Customer Experience & Retention 

Enhance the overall customer experience by demonstrating patience, empathy, and understanding, and provide clear, understandable, & compassionate communication to customers regarding the claim

Must Haves 

● Ability to grasp the domain quickly and develop business insights 

● Exceptional communication skills (Oral and Verbal) 

● Proactive in identifying potential issues and implementing the necessary corrective measures. ● Strong stakeholder management to drive 

● Excellent logical reasoning skills 

● Prior experience managing escalations is preferred. 

● Previous experience of working in hospitals or insurance health claims is advantageous 

● Medical Graduate in any stream (MBBS/BHMS/BAMS/BUMS/BDS) 

● Knowledge of additional languages is a plus, with proficiency in Hindi and English being essential.

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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