Najeb
Najeeb provides a governed AI platform for the health insurance ecosystem in Saudi Arabia and the GCC, unifying approvals, claims, fraud detection, and pharmacy workflows. The platform has processed over 30 million claims and delivers a 50% reduction in approval turnaround time while ensuring compliance with SBS, AR-DRG, and ICD-10 standards.
- Insurance Technology
- Artificial Intelligence
- Healthcare Technology
- Software Only
- Regulatory & Compliance Technology
- Data & Analytics
Funding
Founders
Founder details are not available yet.
Product
Problem
Health insurance claim processing is often manual, slow, and prone to errors, leading to high rejection rates for healthcare providers and increased workload for insurers. Identifying fraudulent claims, conducting pre-authorization checks, and ensuring compliance with regulatory standards like those from the Council of Health Insurance (CHI) in Saudi Arabia become complex and time-consuming tasks.
Solution
Najeeb utilizes artificial intelligence to streamline the health insurance claims lifecycle for insurance companies, healthcare providers, and health software vendors. The platform offers automated pre-authorization checks, medical claims validation, and fraud or abuse detection, reducing manual workload and accelerating approval times. It uses a reasoning engine to deliver justified decisions, providing transparency and improving the accuracy of outcomes. The system also creates a 360-degree patient health profile to help detect inconsistencies across multiple claims, leading to fairer and more consistent decision-making. By continuously monitoring and reassessing risks, Najeeb helps clients adapt to changing patterns and improve operational efficiency. The platform is built specifically for Saudi Arabia and the GCC market, with global benchmarks tuned to local market behavior.
Target Audience
Primary customers include health insurance companies, healthcare providers, and healthcare software vendors operating within Saudi Arabia's and the broader GCC insurance ecosystem.
Features
- AI-driven pre-authorization checks that expedite medical approvals and reduce turn-around times by up to 50%
- Automated detection of fraudulent or abusive claims, including upcoding, duplicate therapy, unbundling, and service overuse patterns
- Reasoning engine that generates justified, auditable decisions for claim approvals or denials
- 360-degree patient health profile for comprehensive risk assessment and claims analysis
- Continuous risk monitoring and reassessment tools to improve long-term decision accuracy
- Compliance-focused features aligned with Saudi standards including SBS, AR-DRG, and ICD-10
- Unified platform covering approvals, claims, pharmacy, coding, motor, fraud, and underwriting workflows
- Proven in production with 30M+ claims processed and serving millions of beneficiaries