Individual skill

payer-ops-review

Review and adjudicate health-plan payer operations cases using a shared payer environment. Use this skill whenever the user asks you to review a prior-authorization case, prepare an appeal disposition, reprice a claim, summarize a peer-to-peer discussion, analyze a therapy margin queue, or perform any structured payer-operations determination that involves querying a Northstar or similar payer environment, pulling case/policy/clinical/document records, and returning a structured JSON answer with a basis audit trail. Also use this skill when the user provides an answer_template.json and task_context.json for a payer domain workflow, or mentions payer operations, utilization management, pharmacy appeals, payment integrity, peer-to-peer review, or therapy margin analysis.

experiments/codex_skill_creator_comparison_deepseek_v4_pro_max/reports/skills/task_group_014/fewshot/opencode/fewshot_attempt_02/SKILL.md

Source commit 5082a777379156a048881e94940d640702e5e09a

What was checked

Matches the observed repository HEAD

Yes

Scanner rules are current

No

Repository scan complete

No

Skill scan complete

Yes

Observed behavior

Not checked yet

Last checked

Nov 6, 2026

These are observations at the recorded commit, not a guarantee of safety. Review the source before running it.

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