I run the billing operations for independent medical practices, and I build the software that runs them. Those two things are usually done by different people at different companies, which is why most practices wait weeks for a report that should take a minute.
I founded Bonfire Revenue in November 2016 and still run it. We handle revenue cycle for independent multi-specialty practices across the country — behavioral health, internal medicine, dental, nurse-practitioner-owned clinics, skilled nursing — on contingency, billed as a percentage of what we actually collect. If the claims don't get paid, we don't get paid. That arrangement is the reason everything below exists.
Early on I did the work by hand like everyone else: eligibility checks in one portal, claim scrubbing in another, patient statements in a third, and a spreadsheet to tell me whether any of it had worked. Hiring more people to do that faster was the obvious move and the wrong one. So I learned to build instead. Across four platforms there are now more than 200 production automations behind the firm — 59 in Make and Boost.space, roughly 70 in Pabbly Connect, roughly 80 in TaskMagic — plus several hundred more built inside the project systems we run day to day. They cover patient statements and payment collection, client onboarding, staff provisioning, denial routing, content and campaign delivery, and the KPI reporting every client sees. I architected all of it and I maintain all of it.
The credentials are real but they're not the interesting part. I'm a Certified Professional Biller and a Certified Billing and Coding Specialist, which means I can read a denial and tell you whether it's a coding problem, a credentialing problem, or an eligibility problem. The useful part is that I can then go build the thing that stops it from happening again — and I know which of those three teams to route it to while I do.
What I'm looking for now is a role where both halves count: revenue operations, business systems, or solutions work at a company that would rather have one person who understands the domain and can ship than two who each only do one.
Preston BoutsisUnedited screen recordings from real build and training sessions — my own voice, my own hands, no slides. Every frame was scanned for client and patient data before it went up; segments that showed any were cut.
A TidyCal booking fires the trigger, and a Pabbly router splits it down two conditional routes depending on what was booked — each one setting its own filters and action steps before it reaches Gmail and the CRM. This is the pattern behind every intake flow I build: one trigger, explicit branches, no silent fallthrough.
Prompting Gemini Pro to generate a Google Apps Script, then doing the part the model can't — configuring it as a manually triggered function that posts a payload to a Boost.space custom webhook, and registering the hook on the receiving end so the scenario actually catches it.
Bonfire Dash is the white-labeled portal our clients log into — dashboard, staff, calendar, tasks, projects, CRM, content, forms, files, automations, onboarding, LMS, training videos. Here I'm generating Instacharts URLs for a client's KPIs and embedding them into a portal page through iFrame blocks.
The same article-generation automations in Taskmagic, taught in Spanish to the team members who run them. Conversational Spanish is on my résumé; this is what that actually buys an employer — I can hand a system to the people who will operate it without routing it through a translator.
Working through SEO metadata on the firm's site in the Wix editor — titles, descriptions, and structure on a page that exists to convert a practice owner into an onboarding call.
Updating images and raw HTML inside a live article in Grigora, including the featured-image alt text. The articles arrive through the automated pipeline; this is the human pass that happens after the approval gate.
Short destination URLs with aliases, UTM parameters, custom social preview cards, deep links, scheduled publication and expiry, and password protection. Every outbound campaign link is built here, which is how the attribution survives the trip.
Bulk-updating staff profile photos across the organization's Zoho Mail user directory — the unglamorous administration that makes a distributed team look like one company in a client's inbox.
Six of the two hundred, picked because they show range rather than repetition. Each diagram is the real shape of the workflow — module counts, branch widths, and approval gates as they actually run in production.
Replaced manual patient billing across the entire client book. One trigger generates the statement, sends it by email and SMS, attaches a hosted payment link, and writes the result back to that client's KPI sheet. Nobody on my team touches a patient statement anymore.
Takes a topic off a queue, generates an SEO-structured article, renders styled HTML, and publishes to the CMS through its API — behind a human approval gate, because an unreviewed article about medical billing is a liability. Each published piece is then repurposed into an email edition and syndicated to LinkedIn and Facebook. Runs unattended, twice daily.
A Chrome and Edge extension that validates patient contact data for medical practices and flags unverifiable records before they enter the pipeline. Clean records become qualified leads in the CRM with automatic campaign enrollment; the rest are held and flagged rather than quietly dialed, which is what keeps the outbound side TCPA-defensible.
A single intake form builds a client's entire nested document tree — 16 folders, correctly permissioned — shares it with the right people, spawns a KPI sheet from template, and creates the company and contact records downstream. The staff version routes new hires to the right team's workspace off a six-way branch. Onboarding used to be a checklist somebody forgot.
Moved the firm's full automation estate between platforms by exporting every scenario as JSON and transforming it programmatically — pruning platform-specific modules at any nesting depth, nulling stale connection and hook references, and stripping regenerable metadata to cut payload size 60%. Hand-rebuilding 59 scenarios would have taken weeks and introduced drift. This was reviewable, repeatable, and diffable.
CRM architecture and integration, automated quote and proposal generation, and multi-channel campaigns across email, SMS, and physical direct mail. Every outbound path sits behind a compliance gate for TCPA and A2P 10DLC — in healthcare the consequence of a sloppy campaign isn't a low open rate, it's a complaint. This engine is what drove the 220% and 310% client growth years.
The contact-validation extension above, in the two walkthroughs I recorded for practices evaluating it.
3:46The side-panel walkthrough for a practice evaluating it — installing, running a record, and reading what comes back.
1:35The short version: where unverifiable contact data costs a practice money, and what the extension does about it before the record enters the pipeline.
Eight live sessions for billers, office managers and physicians across 2022 and 2023, each built around the denials that specialty was actually getting. I wrote the material and ran the room. Just over seven hours in all, and they play right here.
46:54Built around the denial codes pediatric practices actually receive. Spent most of the session on modifier-inconsistency rejections — verifying payer telehealth modifier requirements, knowing when 59 or XE is required on a bundle, and checking bilateral standards before resubmitting.
54:07The front-end work that decides whether a claim gets paid: eligibility verification, coverage checks, and prior authorizations, with the plan-specific traps that catch primary care — Medicare Advantage rules, Medicaid managed-care plans, and payer stipulations tied to a diabetes diagnosis.
56:33The modality codes chiropractic clinics bill every day and the ones they get wrong. Covered unit rules on timed codes, the bundling denials that follow manual therapy, and when a modifier actually fixes the claim versus when it just delays it.
41:09Where to set charges on bracing and durable medical equipment, and how to defend the number. Walked through referencing the Medicare fee schedule, FairHealth estimates for a given zip code, and contracted payer schedules, then landed on charging 120–130% of Medicare as the working norm.
41:17The denial-code families orthopedic practices see most — CO-4 and CO-5 on modifier and place-of-service mismatches, CO-22 and OA-19 when another payer is primary, CO-50 on medical necessity — and the front-end habits that stop each one recurring. A long stretch on third-party liability: when PIP, workers’ compensation or an attorney lien sits ahead of the health plan.
1:16:30The longest session in the series, and most of it is the 8-minute rule — how timed units are counted, where therapy practices over- and under-bill it, and exactly what the resulting denials look like coming back. Also covers the KX and GP modifiers, medical-necessity documentation, and supervision requirements.
1:09:40High-dollar items where a denial leaves the practice holding the product cost. Covered L-code selection for custom-fit versus off-the-shelf orthotics, the skin-substitute Q codes and the application codes that pair with them, prior authorization, and pricing the item against the Medicare fee schedule before anyone dispenses it.
37:33The denial patterns behavioral health practices repeat: CO-16 on incomplete claim data, place-of-service and telehealth mismatches left over from the 2020 shift, and authorizations that lapse mid-course-of-treatment. Walked the evaluation and psychotherapy code set and where each one gets challenged.
Every session ran with open Q&A. A few others in the series — closed-panel credentialing and a second behavioral health date among them — are held back, because attendees name themselves or their practice while asking, and that is not mine to publish.
Not a list of logos. Everything here is something I've built in, administered, or migrated between in production, under a contingency contract where a broken workflow costs the firm money the same week.
Claims Adjuster, UIG — 2016–2017. Auto insurance. I read claims against policy language and decided what was payable. Different industry, same posture as a denial review, and it is the only year of my career spent on the paying side of a claim rather than the submitting side. That is worth more to me now than it sounds.
Sales Team Lead, Ingram Medical — 2014–2016. Inside sales on diabetic supplies against a daily quota of 22. Ranked consistently in the top five for conversion across a sales organization of roughly 150 staff, and promoted to Sales Team Lead for my final six months, running a team of 17 reps.
preston@bonfirerev.com
Salt Lake City, UT — open to remote