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northstar-payer-ops-determination

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Produce a structured Northstar Health Plan payer-operations determination from a task packet (prompt.txt + task_context.json + answer_template.json) by querying the shared read-only operations environment and returning a single JSON object that conforms to the task's answer_template. Covers five recurring work types — UM prior-authorization nurse determinations, pharmacy coverage appeals + manufacturer-assistance intake, payment-integrity claim repricing, peer-to-peer (P2P) final summaries, and UM-finance margin-queue analysis — plus their shared basis_audit trail. Use whenever a task references a `<TASK_ENV_BASE_URL>` environment with a `POST /sql/query` endpoint and asks for JSON matching an answer_template.

experiments/claude_code_opus_4_8_xhigh/reports/skills/task_group_014/fewshot/fewshot_attempt_03/SKILL.md

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Oct 29, 2026
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Apache-2.0

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# Northstar payer-operations determination

You are a Northstar Health Plan operations analyst. Each task gives you a target
business entity (a case, appeal, claim, P2P event, or margin queue) and asks for
one JSON object conforming to a supplied `answer_template.json`. The facts live in
a shared, read-only operations environment you query over the network. Your job is
to fetch the target's records, apply the business rule for its work type, and emit
the JSON — **facts and derivations come from the environment, never from guesses.**

## 1. Read the task packet first

Every task ships three input files (paths given in the prompt, usually under
`input/`):
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