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Sam Cunningham

Director

Healthcare Compliance and Coding Professional

RHIA, CCS

LinkedIn

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. 

Testimonials

"SunHawk demonstrated a commendable commitment to precision and compliance throughout our engagement. Their expertise in navigating complex healthcare regulations was evident, providing us with a thorough and insightful audit. We required assistance with a complex billing audit that required statistical analysis. As a smaller healthcare system, SunHawk provided us a level of audit expertise that we are not able to staff in-house. The team’s responsiveness and industry knowledge make them a valuable partner for healthcare organizations seeking rigorous and reliable auditing services."

Sara Coverstone

Chief Compliance & Privacy Officer
Northern Arizona Healthcare

"SunHawk was an outstanding partner in the provision of interim leadership in compliance and internal audit for our organization.  They provided seamless coverage and advancement of our compliance and internal audit functions.  As CEO, I had no concerns or worries during our engagement.  They were true partners for us!"

Alfred E. Pilong

President and CEO
Garnet Health

"James and the SunHawk team have been an invaluable resource for our Compliance Office - they are a reliable, well experienced, trusted and knowledgeable team of professionals who at a moment’s notice will take your calls or respond to your emails.

Their advice helped us navigate the ever evolving, highly regulated healthcare industry!  Whether it’s discussing report methodology or determining appropriate repayment, SunHawk provides the reassurance and confidence that you are doing the right thing!

We are honored to have partnered with SunHawk and will continue to do so in the future!"

Natasha Cogdill

Vice President/Chief Ethics, Compliance and Privacy Officer
Community Health System

"SunHawk’s professionals are leaders in the compliance and risk industries. Over the years I have worked with a number of their professionals on a series of projects/issues and learned SunHawk’s professionals are problem/solution-oriented and great coalition builders. 

SunHawk Professionals get the job done and are a pleasure to work with. Commitment, Experience, Professionalism, and Integrity; that's what SunHawk Professionals brings to the table."

Gerry Roy

Vice President/Chief Ethics, Compliance and Privacy Officer
Phoenix Children's Hospital

"Jim Rough is among the most conscientious professionals I have encountered. When he says he is going to do something -- he does it. Jim has a broad range of experience gained over decades in leading organizations.

Now as the founder of his own firm, Jim will be enabled to provide the same high-quality service to his clients in a setting that allows greater customization to his clients' financial circumstances."

Frank M. Placenti

Chair, US Corporate Governance & Securities Regulation
Practice, Squire Patton Boggs

"SunHawk Consulting's HIPAA Check Program provided us with an invaluable third-party review of our HIPAA policies and practices. The tracking tool SunHawk includes with the Program has become an integral part of our continued monitoring for HIPAA compliance.

Jan Elezian's extensive hands-on compliance experience was evident during site visits and staff interviews as she translated difficult subject matter into practical use scenarios and provided quality feedback. Thank you SunHawk team!"

Nancy Lipman

Vice President, Compliance
Chicanos Por La Causa, Inc.

"SunHawk provides an array of dynamic professionals, each with significant subject matter expertise and a problem-solver approach. Beyond their knowledge and conscientious work ethic, however, is a team of caring individuals who strive to furnish individualized, tailored assistance with a personal touch. 

Jim Rough's dedication to the success of SunHawk clients is evidenced by his strategic and prospective thinking complemented by his ability to truly anticipate the needs of a company in the midst of the complicated compliance climate. I highly recommend SunHawk for companies of any size seeking actionable solutions and measurable results."

Michelle Missal

Vice President and Chief Compliance Officer
Paragon 28, Inc.

“Sunhawk Consulting has proven to be a trusted partner with the ability to deliver results. We have consistently been impressed with their expertise, professionalism, and commitment to customer service.  Sunhawk Consulting has supported our enterprise-wide risk assessment, risk management activities, and the configuration of our Governance, Risk and Compliance software tool.

Sunhawk Consulting’s leadership and consultative services have helped us to successfully navigate through the complexities of SOC, HIPAA, NIST and FedRAMP audits this year.  The knowledgeable team of Sunhawk professionals has been and continues to be an invaluable resource for us, ensuring we are positioned for success in all our audits and assessment activities.”

Zachary Fain

Chief Technology Officer (CTO)
Signature Performance

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SunHawk Consulting

2550 E Rose Garden Ln.
Unit 72016
Phoenix, AZ 85050
info@sunhawkconsulting.com

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