Front End Revenue Integrity Coordinator

Overview Company Summary If you are searching for a fulfilling place to develop your career and an opportunity to make a difference in helping others, then keep reading on. Here at AAC, we have a progressive culture; we listen to your ideas, value a work/life balance, invest in education, and we foster trust and respect for all individuals. Our exceptional comp and strong benefits include company matching 401K, medical, dental, vision and life insurance. We are looking for our future leaders, who are not only going to fill the qualifications for this job description, but who are going to exceed expectations. Be a part of a team whose mission isto provide quality, compassionate, and innovative care to adults struggling with addiction and co-occurring mental health disorders.Our purpose and passion are to empower patients, their families, and our communities by helping individuals achieve recovery and optimal wellness of the mind, body, and spirit. Responsibilities Job Summary: 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. Key Responsibilities: Insurance Eligibility Monitoring 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 Premium payment issues Identify changes in insurance status that could impact reimbursement. Escalate coverage concerns to appropriate facility personnel for timely resolution. ACA Policy Management Conduct routine eligibility reviews for ACA Marketplace policies. Identify: Unpaid premiums Grace periods Pending or completed policy terminations Communicate findings and recommended next steps to facility teams. Monitor outstanding issues through resolution to minimize reimbursement risk. Coordination of Benefits (COB) Management Perform routine Coordination of Benefits (COB) verification reviews. Identify: Multiple active insurance policies Incorrect primary or secondary payer sequencing Missing or outdated COB information Communicate required updates to facility teams. Monitor and track outstanding COB issues through resolution to reduce preventable claim denials. Facility Communication & Resolution 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. Revenue Integrity & Denial Prevention 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. Vendor & Revenue Cycle Collaboration 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. Data Integrity & Documentation 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. Qualifications Education & Experience: High school diploma or equivalent required. Associate's or Bachelor's degree in Business, Healthcare Administration, Finance, or a related field preferred but not 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 ○ Healthcare reimbursement processes Experience using eligibility verification platforms (e.g., Availity) preferred. Experience using Salesforce, Google Workspace, and revenue cycle software applications preferred. 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. Core Competencies Revenue Integrity Insurance Eligibility & Coverage Analysis Coordination of Benefits (COB) Denial Prevention Revenue Cycle Knowledge Critical Thinking & Problem Solving Process Improvement Cross-Functional Collaboration Organization & Time Management Attention to Detail Documentation Accuracy Customer Service & Professional Communication Physical Requirements AAC is committed to principles of equal opportunities for all employees. The Company will provide reasonable accommodations that are necessary to comply with State and Federal disability discrimination laws. Prolonged sitting at a desk Must be able to lift 15 pounds at a time American Addiction Centers is an equal opportunity employer. American Addiction Centers prohibit employment practices that discriminate against individuals or groups of employees based on age, color disability, national origin, race, religion, sex, sexual orientation, pregnancy, veteran or military status, genetic information or any other category deemed protected by state and/or federal law. #J-18808-Ljbffr American Addiction Centers