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If you have an e-mail account setup under the configuration tab>server settings>notification server settings>e-mail configuration.  Any e-mail sent to that address gets turned into an Incident with the subject of the e-mail becoming the subject of the Incident.  If the sender of the e-mail is a contact, the sender becomes the contact of the new Incident.  The Incident is assign to whatever worker is the 'route to this worker by default' on the incident tab>admin>list routing rule (bottom of page), if no other routing rule is in place.  By using an embeded data island in the incoming e-mail you can populate most of the other fields as well.  We use this in a number of our processes all day long, especially for on boarding....very powerful....hope this gets you going in the right direction

1. Admin > E-mail Inboxes > New E-mail Inbox
2. Choose POP3 or IMAP
3. Enter a name for the inbox, then enter server name, account username, account password, and test the connection.
4. Determine whether you want to reject unknown addresses (that is, only auto-generate from e-mails associated with Contacts Helpdesk already knows), or accept.  And if you don't reject unknown addresses, do you want to create contacts or not create contacts if Helpdesk hasn't seen that e-mail before?
5. Select filters to apply to this inbox.  Filters can reject messages that meet specific criteria, preventing them from becoming incidents.  For example, you probably don't want to create tickets for Out of Office notifications!  You can use the pre-defined filter or add your own at Admin > E-mail Filters > New E-mail Filter
6. Enter an e-mail address for error reports to go to.  Probably your inbox.
7. You can then set fields for new incidents and for existing incidents.  Existing incidents are those where the e-mail's subject line contains the incident number in the format #number, for example if the Subject line was "RE: Incident #64978 - Thank you for your Helpdesk submission", this will be handled as an 'existing' incident.  If the subject line does not include an incident number, a new incident will be created.  For example, maybe you want a particular Worker or Queue to handle all e-mail submitted incidents before they move to other groups.  For new incidents, set Worker to your queue name, 'Level 1 Service Desk.'  You get the idea.
8. Click OK to save the inbox.  It will be processed accordingly.  The incident Title will be the e-mail's Subject line, the first Comment is set to the e-mail's Body.  Any attachments are uploaded to the ticket.

You can set up multiple inboxes if you want multiple rules.  For example, let's say you yourself are often approached in the hallway with user requests.  You could create the inbox helpdeskrob@yourdomain.com, and set up special rules for routing e-mails, like assigning new incidents to yourself.  Or you could use individual inboxes for alerts, like helpdeskserveralerts@yourdomain.com, assigning new tickets to your System Administrator queue with a category of Server\Monitoring and Alerts.

ServiceDesk provides more options for inbox processing, but you can get it done in Helpdesk by using multiple inboxes.


The Helpdesk User Guide talks a little more about filters and other e-mail inbox monitoring options like data islands:
http://www.altiris.com/upload/helpdesk_004.pdf

I got this setup, but it is deleting any emails that get rejected by my filters?  Is there a way to tell it to NOT delete the rejected emails and keep them alive in the inbox I am monitoring?

Altiris is setup so whenever an E-Mail is brought into Altiris it is deleted from the In Box.  I have created a Backup E-Mail address and a rule on my exchange server....  whenever an e-mail goes to the Primary E-Mail Address it SENDS A COPY to the Backup Address.....this is working well for us.