Our Team

JULIE SYLVESTRE, FACMPE - experienced healthcare management industry professional

Julie Sylvestre, FACMPE, President and Owner

Working in the healthcare management industry since 1986, Julie joined Comprehensive Practice Management in 2002 as Director of Operations and expanded to take on co-ownership of the company.

In 2018 Julie purchased the company to become the sole owner of CPM and decided to reposition the company for growth. In order to stand out in the industry on a national scale, CPM was rebranded as Grey Ledge Medical Management in June of 2019. The name comes from the work complex in which their office is located.

Julie has used her 20+ years of healthcare leadership to expand services offered to physician practices, making Grey Ledge Medical the “first call” for the many operational and financial issues experienced in a medical practice.

Outside of Grey Ledge Medical, Julie achieved her fellowship in the American College of Medical Practice Executives (ACMPE), the highest level of distinction in the medical practice management profession. Julie is also active in the local and national chapters of the Medical Group Management Association (MGMA).

KAREN MARCOUX, CPC - DIRECTOR OF OPERATIONS - medical practice consultant.

Karen Marcoux, CPC, Director of Operations

Starting her career as a medical assistant in 1997, Karen performed both clinical duties and administrative tasks, giving her the unique perspective and understanding of the myriad of responsibilities required to run a successful medical practice.

In 2016, Karen became Director of Operations, the role she holds today. Her responsibilities are liaising with management to maximize operational efficiency and set strategic goals, mentoring and monitoring the Grey Ledge Medical billing staff and supervision of day-to-day business operations to ensure smooth progress and efficient workflow. Karen has been instrumental in the company’s expansion as a well-established medical billing company providing services to over 100 providers throughout New England.

In addition to her responsibilities at Grey Ledge Medical, Karen is a Certified Professional Coder (CPC) 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).

SHARON PARAYNO -Intergy Practice Management - Electronic Health Record (EHR) Trainer - Certified Professional Coder CPC

Sharon Parayno, CPC

Sharon joined CPM in May 2014 as our Intergy Practice Management, Electronic Health Record (EHR) Trainer and MACRA/MIPS/Meaningful Use liaison. Sharon is a Certified Professional Coder (CPC) with the American Academy of Professional Coders (AAPC).

In 2016, Sharon also took on the role as Manager of Client Services. In this expanded role, Sharon is a liaison between Grey Ledge Medical's staff and our client's office. She continually relays information to maximize operational efficiency and offers time-saving suggestions to our clients and staff.

Prior to becoming a system’s trainer, Sharon spent many years working in physician practices in roles ranging from Medical Assistant to Billing and Office Manager. This understanding of the real-life challenges of physician practices gives Sharon unique knowledge which proves to be beneficial when customizing software and training physicians, care-givers and office staff.

She is a Certified Medical Assistant and has a bachelor’s degree in Business Management. Sharon has been training physician practices on EHR and Practice Management Systems since 2002.

BONNIE MARCOUX - Medical Billing Specialist - Coding Trainer .

Bonnie Marcoux

Bonnie started with CPM in 2002 as a Medical Billing Specialist. Since her time at Grey Ledge Medical, she has worked in many different roles and is a member of the Senior Management Team.

Bonnie’s current responsibility is to manage Grey Ledge Medical’s eClinical Works (eCW) billing team and serve as the liaison between each of its eCW and EPIC clients and Grey Ledge. She has a keen understanding of several different medical billing software products including Intergy by Greenway, EPIC, eClinical Works, PrimeSuite by Greenway and Medical Manager.

Over the years she has become proficient in the billing requirements for many different specialties, including Primary Care, Urgent Care, Gastroenterology, Neurosurgery, Neurology and Pain Management.