Individual skill

northstar-payer-operations

Payer operations analyst for Northstar Health Plan. Navigate a shared read-only SQL and API environment for utilization management, prior authorization, pharmacy appeals, payment integrity repricing, peer-to-peer final determinations, and therapy margin analysis. Use when the task is a Northstar payer workflow (UM nurse review, appeals coordinator, payment integrity analyst, peer-to-peer coordinator, or UM-finance queue analysis) that requires structured determination outputs with business audit trails.

experiments/codex_skill_creator_comparison_deepseek_v4_pro_max/reports/skills/task_group_014/fewshot/codex/fewshot_attempt_03/SKILL.md

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Last checked: Nov 6, 2026

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Repository stars (not skill ratings): 121
Repository last updated: Oct 29, 2026
License: Apache-2.0

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references/workflows.mddoc · 8,596 bytes

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# Northstar Payer Operations

Shared payer-operations environment for UM, appeals, payment review, and queue analysis. Every task uses the same environment and follows three stages: discover the schema, gather the evidence, and produce the determination.

## Environment

Base URL from the task context. All requests need:

```
[Credential-related source omitted]
```

**SQL endpoint** (primary tool):