Sam Cunningham
Sam Cunningham, RHIA, CCS
Sam Cunningham is a Senior Associate at Epsilon Life Sciences. He specializes in compliance and coding matters and has over 18 years of Health Information Management (HIM) experience working with payers and providers, including large public health systems, acute care hospitals, ambulatory surgical centers, physician practices, home health agencies, group home agencies, managed care organizations, state and local agencies, the Centers for Medicare and Medicaid Services (CMS), and healthcare private equity companies. Sam has supported clients with pre-acquisition due diligence, risk assessments, coding and billing compliance, clinical documentation compliance, enterprise compliance, internal audit co-sourcing support, revenue cycle denials, disputes, and government assistance program administration.
He has held leadership roles as an HIM Director and interim HIM Director at various health care entities, including inpatient rehabilitation and pediatric facilities. Sam has also served as the Director of HIM Services, where he managed and outsourced coding departments and clinical documentation improvement to both domestic and global staff.
Sam has significant experience working as a Recovery Audit Contractor (RAC), where he conducted audits of inpatient and outpatient hospital coding audits, and initiated new assessment protocols and database queries to optimize coding quality through complex chart reviews involving medical necessity, clinical validation, place of service and coding guidelines.
He also has experience serving as support for expert reports on various matters including coding, damages, self-disclosures, clinical validation, and benchmarking analyses.
Sam holds national certifications with the American Health Information Management Association (AHIMA) as a Registered Health Information Administrator (RHIA) and Certified Coding Specialists (CCS), and has a Bachelor of Science, Health Information Management, from Temple University.