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Julie Sylvestre, CMPE, President and Owner

Julie Sylvestre, CMPE serves as President at Comprehensive Practice Management Services, Inc. (CPM) and oversees all of the services offered by CPM. Julie’s work experience in the health care industry began in 1986, when she started working for a 100+ physician multi-specialty group located in Southboro, Massachusetts. At this practice, Julie manage the group’s 12-physician multi-specialty satellite office in Natick, Massachusetts for 9 years.

Julie then went onto Beth Israel/Deaconess Hospital (BIH) in Boston, Massachusetts to build the infrastructure of their new MSO, Medical Care of Boston (now known as Affiliated Physicians Group – APG). During her time at BIH, Julie managed the financial and operational aspects for 9 physician practices throughout the Boston area. In 1995, Julie joined Coastal Medical, Inc. in Providence, RI as their Director of Operations and was one of the initial administrative personnel for the newly forming primary care group practice. During her years at Coastal Medical, Julie oversaw the company’s growth from 17 physicians and 60 employees to 60 physicians, 17 offices and 230 employees. Julie was responsible to merge the operational processes, procedures and guidelines among the various offices and to develop and negotiate new services on behalf of the group. These processes included combining accounts receivable, accounts payable, human resources and other operational processes throughout the organization.

In 2002, Julie joined the newly formed Comprehensive Practice Management Services, Inc. as the Director of Operations. CPM had been launched as a third party medical billing company, providing services throughout Rhode Island. Since then, Julie has purchased the company and has expanded the services offered to physician practices, making CPM the “first call” for the many operational and financial issues experienced in an independent practice.

In addition to her responsibilities to CPM, Julie is active in the local and national chapters of the Medical Group Management Association (MGMA), where she served as the President of the MA/RI MGMA chapter from June of 2012 to June of 2013. She continues to maintain and grow her legislative contacts in Washington, DC, so that all of the CPM clients are aware of the laws and regulations that will affect physician practices in the many years to come. She has achieved her certification as a Medical Practice Executive (CMPE). She is also involved in the Find Your Bold organization, a local non-profit that is committed to empowering individuals to conquer their fears and perceived limitations.


Karen Marcoux, CPC, Director of Operations

Karen A. Marcoux, CPC serves as Director of Operations at Comprehensive Practice Management Services, Inc (CPM).

Karen’s work experience in the health care industry began in 1997, when she began working as a medical assistant in several urgent care and primary care practices.  In these roles, Karen performed both clinical duties and administrative tasks, now giving her the unique perspective and understanding of the myriad of responsibilities required to run a successful medical practice.

In 1999, Karen joined CPM as a medical billing specialist.  At that point, CPM was a relatively new company having six medical billing clients.  Karen quickly moved up the ranks to an Account Manager, where she was responsible for managing a team of employees working on some of CPM’s largest clients.

In 2008, Karen was promoted to Manager of Client Services.  In this role, Karen was responsible for meeting with all of CPM’s clients to review their financial information and acting as the liaison between the practice and CPM to establish efficient work processes and quality improvement.

In 2016, Karen became Director of Operations at CPM, the role she holds today.  Her responsibilities are liaising with management to maximize operational efficiency and set strategic goals,  mentoring and monitoring CPM’s billing staff and supervision of day-to-day business operations to ensure smooth progress and efficient workflow.

Over the course of the nearly 20 years with CPM, Karen has been instrumental in the company’s expansion into a well-established medical billing company providing services to over 100 providers throughout New England.

In addition to her responsibilities at CPM, Karen is a Certified Professional Coder and an active member with the American Academy of Professional Coders (AAPC).  She is also a member of the Massachusetts/Rhode Island Medical Group Management Association (MA/RI MGMA).  By continuing to grow her knowledge through these professional associations, Karen strives to educate all CPM clients with the latest medical compliance and reimbursement policies.


Bonnie Marcoux,
Bonnie started with CPM in 2002 as a Medical Billing Specialist. Since this time, she has worked in many different roles and currently is a member of CPM’s Senior Management Team. Bonnie’s current responsibility is to manage CPM’s eClinical Works (eCW) billing team and serve as the liaison between each of our eCW and EPIC clients and CPM. She has a keen understanding of several different medical billing software products including Medical Manager, Intergy by Greenway, EPIC, and eClinical Works. Over the years she has become proficient in the billing requirements for many different specialties which include Primary Care, UrgentCare, Gastroenterology, Neurosurgery, Neurology and Pain Management.



Sharon Parayno, CPC,

Sharon has been working at CPM since May 2014 as our Intergy Practice Management, Electronic Health Record (EHR) Trainer and MACRA/MIPS/Meaningful Use liaison.  She is a Certified Medical Assistant and has a Bachelor’s Degree in Business Management.    She has been training physician practices on EHR and Practice Management Systems since 2002.  Previous to becoming a system’s trainer, she’s spent many years working in physician practices in roles ranging from Medical Assistant, Billing Manager and Office Manager.  This understanding of the real-life challenges of a physician practices, gives Sharon unique knowledge which proves to be beneficial when customizing software and training physicians, care-givers and office staff.