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The determination of per- and polyfluoroalkyl substances (PFAS) in environmental samples, such as drinking waters, requires the design of high performing and versatile sensing strategies. Label-free biosensing platforms based on specialty fiber optics are a valid option to face this challenge. Among them, lossy mode resonance (LMR) fiber optic biosensors are showing remarkable performance in terms of detection limit, selectivity, and reproducibility. The detection of small molecules, such as perfluorooctanoic acid (PFOA), can be achieved with the help of well-designed biological recognition layers. In this study, the biosensing potentialities of a label-free LMR-assisted optical platform based on nanocoated fibers are investigated. Delipidated human serum albumin (hSA) was used as biological recognition layer for PFOA in aqueous solution. Different fiber functionalization protocols based on the covalent immobilization of hSA were tested. The conformational changes related to the formation of hSA/PFOA complex were followed via optical monitoring of LMR spectral shift, showing a trend that can be modeled with Langmuir adsorption isotherm. These results confirmed the potentiality of LMR-based fiber biosensors for the detection of small molecules, such as PFOA, in synthetic samples.