Front End Revenue Integrity Coordinator

American Addiction Centers•Las Vegas, NV

4d•Remote

About The Position

The Front-End Revenue Integrity Coordinator plays a critical role in protecting organizational reimbursement by proactively identifying and resolving insurance eligibility, ACA coverage, and Coordination of Benefits (COB) issues before claims are submitted. Through centralized monitoring, collaboration with facility teams, and timely issue resolution, this position helps reduce preventable claim denials, improve reimbursement accuracy, and strengthen front-end revenue cycle performance across multiple treatment facilities. This position is responsible for ongoing insurance eligibility re-verifications, monitoring ACA Marketplace policies, identifying coverage risks including grace periods and policy terminations, validating Coordination of Benefits (COB) information, and ensuring facilities receive timely communication to resolve issues that could impact reimbursement. Reporting to the Director of Financial Case Management, this is a non-patient-facing, remote support position that partners with Admissions, Facility Operations, Utilization Review, Revenue Cycle, and third-party business partners, including Hansei and FinPay, to improve reimbursement outcomes, strengthen insurance compliance, and support front-end revenue cycle operations across the organization.

Requirements

High school diploma or equivalent required.
Minimum of two (2) years of experience in healthcare insurance verification, eligibility, patient access, medical billing, revenue cycle, or a related healthcare financial role required.
An equivalent combination of education, training, certifications, and relevant work experience may be considered in lieu of a college degree.
Working knowledge of Commercial insurance, ACA Marketplace plans, Coordination of Benefits (COB), Insurance eligibility verification, Managed Care principles, and Healthcare reimbursement processes.
Strong analytical and critical thinking skills with exceptional attention to detail.
Excellent written, verbal, and interpersonal communication skills.
Ability to prioritize multiple responsibilities while maintaining accuracy in a fast-paced environment.
Demonstrated ability to work independently and collaboratively across multiple departments.

Nice To Haves

Associate's or Bachelor's degree in Business, Healthcare Administration, Finance, or a related field preferred but not required.
Experience using eligibility verification platforms (e.g., Availity) preferred.
Experience using Salesforce, Google Workspace, and revenue cycle software applications preferred.

Responsibilities

Perform ongoing insurance eligibility re-verifications for ACA Marketplace plans and other designated insurance products throughout a patient's treatment episode.
Monitor insurance coverage for active eligibility, coverage terminations, grace period status, and premium payment issues.
Identify changes in insurance status that could impact reimbursement.
Escalate coverage concerns to appropriate facility personnel for timely resolution.
Conduct routine eligibility reviews for ACA Marketplace policies.
Identify unpaid premiums, grace periods, and pending or completed policy terminations.
Communicate findings and recommended next steps to facility teams.
Monitor outstanding issues through resolution to minimize reimbursement risk.
Perform routine Coordination of Benefits (COB) verification reviews.
Identify multiple active insurance policies, incorrect primary or secondary payer sequencing, and missing or outdated COB information.
Communicate required updates to facility teams.
Monitor and track outstanding COB issues through resolution to reduce preventable claim denials.
Serve as the primary point of contact for facility teams regarding insurance eligibility and coverage concerns.
Communicate insurance changes requiring immediate action to prevent interruptions in reimbursement.
Partner with facility staff to resolve insurance eligibility, ACA coverage, and COB issues before claims are submitted whenever possible.
Monitor outstanding issues through resolution and provide ongoing follow-up to ensure timely completion.
Document communications, actions taken, and issue resolution within designated revenue cycle systems.
Collaborate with internal departments and third-party revenue cycle partners, including Hansei and FinPay, to facilitate communication, resolve insurance and reimbursement issues, maintain accurate documentation, and support front-end revenue cycle initiatives.
Coordinate information exchange between facilities, vendors, and corporate revenue cycle teams to promote timely issue resolution and continuity of operations.
Monitor insurance eligibility reports to identify trends that may negatively impact reimbursement.
Identify recurring eligibility, COB, and coverage issues contributing to preventable claim denials.
Collaborate with leadership to recommend workflow improvements that strengthen front-end revenue cycle processes.
Maintain reports and tracking tools that support insurance monitoring and denial prevention initiatives.
Support departmental goals focused on improving reimbursement, reducing preventable denials, and increasing revenue integrity.
Assist with insurance-related audits and compliance initiatives as assigned.
Develop and maintain effective working relationships with third-party revenue cycle vendors, including Hansei and FinPay.
Coordinate the exchange of eligibility, insurance, payment, documentation, and other revenue cycle information necessary to support reimbursement activities.
Assist with documenting, tracking, and resolving insurance or payment issues identified by internal teams or external partners.
Support implementation of new revenue cycle workflows, technology enhancements, and process improvements involving vendor partners.
Participate in meetings, process reviews, testing, and special projects involving external revenue cycle vendors as assigned.
Maintain accurate documentation within Salesforce and other designated revenue cycle systems.
Ensure eligibility findings, COB updates, and insurance communications are documented accurately and timely.
Maintain organized and audit-ready documentation supporting reimbursement activities.
Ensure tracking tools and departmental reports remain accurate and up to date.