I do something similar to the others, but often after getting an idea of what abilities I want in the creature, I then think about how I could get those abilities by using/modifying an existing creature (adding a class level or template) and then just "re-skinning" it.
For example, I wanted a giant demonic bug that could tunnel up under a group of enemies, attack them all, grab one, and then pop back into the ground. What I wound up going with was an umberhulk with a level of cleric for Travel Devotion, the Whirlwind Attack feat, and something that granted Improved Grab (or maybe they already have that, I forget). I just described it as looking like a giant demonic beetle, and flavored the Travel Devotion as an inherent ability rather than something from a class. I never actually wound up using the Confusion gaze, but did add that into the description when a PC rolled really high on a Knowledge check to identify it.
Sometimes I look at an existing monster and think "That would be so much better if you just changed the feats around and used better tactics". So that's exactly what I do with it.
I definitely try to choose things with the correct CR, or at least close enough so that I can get there by adding only a few levels, hit dice, a template, etc. I still eyeball it to make sure it still seems like an appropriate CR after modifying it of course, since many of the CRs are completely bonkers as printed, especially if you start using templates and things like that.