If anyone is looking for an answer to this. If the user hits the Home button while the interstitial ad is being shown, this prevents it from showing when the user launches the app again.
In your AndroidMainifest.xml file add: android:noHistory="true" to the AdActivity activity
Like this:
<activity android:name="com.google.android.gms.ads.AdActivity"
android:noHistory="true"
android:configChanges="keyboard|keyboardHidden|orientation|screenLayout|uiMode|screenSize|smallestScreenSize"
</activity>
This seems to be working so far.