Sam Cunningham
Director
Healthcare Compliance and Coding Professional
RHIA, CCS
Career Highlights
- Developed annual risk assessments and work plans for one of the largest public health systems in the country.
- Led business development opportunities resulting in multi-year $3.5M win for green space clients and services
- Performed and managed HHS-RADV IVA services for four of the largest health plans in the southwest U.S. participating in the ACA Healthcare Exchange.
- Certified Coding Specialist (CCS)
- Registered Health Information Administrator (RHIA)
Sam Cunningham is a Director with SunHawk Consulting and a healthcare compliance professional with over 15 years of Health Information Management (HIM) experience working with payers and providers. He has supported clients with pre-acquisition due diligence, risk assessments, coding and billing compliance, enterprise compliance, internal audit, revenue cycle denials, disputes, and self-disclosures.
He has helped payers and providers implement coding edits and benchmark analyses for HEDIS/Stars measures, Risk Adjustment, DRGs and professional fee services. Sam has designed coding compliance programs, workplans, and conducted coding quality assessments for many different healthcare services and settings.
Sam has served as the Independent Review Organization (IRO) responsible for assessing a company’s compliance with its Corporate Integrity Agreement (CIA), and reporting findings to clients and the Office of Inspector General (OIG). He has also served as the Initial Validation Auditor (IVA) for health plans participating the Affordable Care Act (ACA) and subject to Risk Adjustment Data Validation (RADV) audits.
Sam has held leadership roles as a HIM Director at various health care entities, including inpatient rehabilitation and pediatric facilities. He has also served as the Director of HIM Services for a vendor company where he managed an outsourced coding department of domestic and global coders.
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SunHawk Consulting
2550 E Rose Garden Ln.
Unit 72016
Phoenix, AZ 85050
info@sunhawkconsulting.com
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