There are different levels of hockey, depending both on skill and age. Tier hockey refers to the upper levels of hockey and includes the AA and AAA levels. AAA (higher than AA) refers to one of the highest levels of amateur or minor professional hockey. This is a similar ranking system as used by Baseball. This does apply to professional minor league hockey, such as the AHL being considered AAA and the ECHL considered AA, both being minor leagues and both being professional leagues.
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AAA hockey is using the analogy of the minor league baseball system, where as the AAA team is the top team in the minors before making it to the MLB team to which the players are signed. This is an easy way to explain the American Hockey League in their relationship to the NHL, as the are the top farm league. For example, the Rockford IceHogs are the AHL affiliate of the Chicago Blackhawks. Corey Crawford, now the starting goalie for the Blackhawks, played in Rockford for 3 seasons. Antti Niemi, who helped carry the Blackhawks to the Stanley Cup last year, played in Rockford the year before. Although hockey may not have quite as many levels in the development process as baseball, it is a very well developed system.
Yes, AAA is considered elite amateur hockey. Youth hockey leagues tend to be rated by age and skill level with AAA being the top level.