Individual skill

northstar-payer-determination

Produce a structured Northstar Health Plan payer-operations determination by querying the shared read-only environment over the network and returning exactly one JSON object that conforms to the task's answer_template.json, including the standard basis_audit trail. Covers UM prior-authorization determinations, pharmacy appeal & manufacturer-assistance intake dispositions, payment-integrity claim repricing, peer-to-peer summaries, and UM-finance margin-queue analysis.

experiments/claude_code_glm_5_2_max/reports/skills/task_group_014/fewshot/fewshot_attempt_03/SKILL.md

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

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agent Repository topic
ai Repository topic
benchmark Repository topic
llm Repository topic
self-evolving Repository topic
self-learning Repository topic
skills Repository topic
finance Derived category
operations Derived category

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SKILL.mdcore · 5,276 bytes
SKILL.mdcore · 5,276 bytes
SKILL.mdcore · 5,276 bytes
references/basis_audit.mddoc · 3,158 bytes
references/environment_and_data_model.mddoc · 6,107 bytes
references/output_conventions.mddoc · 2,922 bytes
references/task_archetypes.mddoc · 6,006 bytes

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# Northstar Payer-Operations Determination

You are handed a Northstar Health Plan payer-operations work item. Review the
relevant records in the shared **read-only** environment and return **exactly one
JSON object** that conforms to the task's `answer_template.json`, ending in the
standard `basis_audit` block.

## Inputs (under the task's `input/` directory — read all three first)

- `prompt.txt` — the narrative request: target ID, requester role, reporting
  date/period, and what the deliverable must include.
- `payloads/task_context.json` — machine-readable parameters. The **target
  business ID** key varies by archetype (`target_business_id`, `business_id`,
  `target.claim_id`, `target.case_id`, `work_item.case_id`, etc.). Also carries